What question did this study set out to answer?

To characterize long-term ventricular defibrillation energy requirements across two years of follow-up in patients with biphasic nonthoracotomy defibrillators.

September 1, 1998Journal of Cardiovascular Electrophysiology

Long‐Term Evaluation of the Ventricular Defibrillation Energy Requirement

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Why the study?

Does the defibrillation energy requirement change over 2 years in patients with biphasic nonthoracotomy defibrillators?

Population

31 consecutive patients with a biphasic nonthoracotomy defibrillation system

Design

Cohort

Follow-up

2 years

Authors

TTTakashi TokanoJuntendo University FPFrank PelosiElectrophysiology MEMATTHEW ELEMMINGUniversity of Michigan

Discussion

Member takes

Implication

Mean thresholds stable over 2 years in most patients; leaves open whether serial testing improves safety in the 15% with ≥10 J rises.

Key Points

To characterize long-term ventricular defibrillation energy requirements across two years of follow-up in patients with biphasic nonthoracotomy defibrillators.
Followed N=31 consecutive patients who received a biphasic nonthoracotomy defibrillation system.
Assessed defibrillation energy requirements via a step-down protocol (20 J down to 1 J) at implant, 24 hours, 2 months, 1 year, and 2 years.
Mean energy requirements showed no statistically significant change over 2 years: 10.9±5.5 J at implant, 12.3±7.3 J at 24 hours, 11.7±5.6 J at 2 months, 10.2±4.0 J at 1 year, and 11.7±7.4 J at 2 years (P = 0.4).
Defibrillation energy requirements increased by ≥10 J after 2 years in 5 patients (~16%), with 1 patient (3%) losing an adequate safety margin and requiring device system revision.

Structured PICO

Does the defibrillation energy requirement change over 2 years in patients with biphasic nonthoracotomy defibrillators?

Population

31 consecutive patients with a biphasic nonthoracotomy defibrillation system

Intervention

Defibrillation energy requirement testing using a step-down technique (20, 15, 12, 10, 8, 6, 5, 4, 3, 2, and 1 J) during defibrillator implantation, and then 24 hours, 2 months, 1 year, and 2 years after implantation

Outcome

Defibrillation energy requirement over 2 years of clinical follow-upsurrogate

While mean defibrillation energy requirements remain stable over 2 years, a subset of patients experience significant increases, suggesting yearly evaluation may be appropriate.

Cite This Study

Tokano et al. (1998) studied this question.

synapsesocial.com/papers/6a6f89e835aa2c282ce0e3fa https://doi.org/10.1111/j.1540-8167.1998.tb00132.x

Topics

Ventricular arrhythmias Cardiac device therapy

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Long‐Term Evaluation of the Ventricular Defibrillation Energy Requirement

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Long‐Term Evaluation of the Ventricular Defibrillation Energy Requirement

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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