Key result
Amiodarone therapy significantly increased the probability of high defibrillation energy requirements during nonepicardial lead system placement (OR 5.46; P=0.002).
Why the study?
What are the predictors of high defibrillation energy requirements during nonepicardial lead system placement?
Observational (n=100)
What are the predictors of high defibrillation energy requirements during nonepicardial lead system placement?
Odds Ratio: 5.46
p-value: p=0.002
Amiodarone therapy significantly increases the probability of requiring high defibrillation energy during nonepicardial lead system testing.
May identify patients prone to high DER with NELS; hypothesis-generating and requires prospective validation before guiding practice.
The determinants of high defibrillation energy requirements (DER) using nonepicardial lead systems (NELS) have not been well characterized. The goal of this study was to examine prospectively the influence of clinical, radiographic, echocardiographic, and procedural variables on DER during NELS placement. Data from 100 consecutive patients undergoing attempted NELS implantation were analyzed. Transvenous leads, subcutaneous patches, and monophasic shock devices from two manufacturers were used. Leads were successfully positioned for testing in 95% of patients. An adequate DER (< or = 25 J) was obtained in 73 of 95 (77%) of patients. Univariate analysis identified amiodarone therapy and left ventricular mass as predictors of high DER. With multivariate analysis, amiodarone therapy was the sole significant predictor of high DER (P = 0.002, odds ratio 5.46). The 22 patients with high NELS DER also had high epicardial DER (mean 24 +/- 9 J). The two patch epicardial DER was > 25 joules in 12 of 22 patients. Thus, adequate DER with monophasic shock waveforms can be obtained in most patients undergoing NELS testing. However, amiodarone therapy significantly increases the probability of obtaining high DER.
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Kopp et al. (1995) conducted an observational in Patients undergoing attempted nonepicardial lead system (NELS) implantation (n=100). Amiodarone therapy vs. No amiodarone therapy was evaluated on High defibrillation energy requirements (> 25 J) (OR 5.46, p=0.002). Amiodarone therapy significantly increased the probability of high defibrillation energy requirements during nonepicardial lead system placement (OR 5.46; P=0.002).
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