October 1, 1992Circulation
Clinical characteristics and outcome of patients with high defibrillation thresholds. A multicenter study.
Why the study?
Does ICD implantation improve survival in patients with high defibrillation thresholds?
Population
87 patients with a defibrillation threshold greater than or equal to 25 J, mean age 59.5 years, 93% male…
Comparison
Implantable cardioverter-defibrillator… vs No ICD implantation
Design
Cohort
Follow-up
up to 5 years
Authors
Discussion
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Member takes
Implication
ICD implantation was associated with higher survival in high-DFT patients; leaves open whether RCTs would confirm benefit given residual arrhythmic risk.
Structured PICO
Does ICD implantation improve survival in patients with high defibrillation thresholds?
P
Population
87 patients with a defibrillation threshold greater than or equal to 25 J (excluding 3 who received ICDs delivering >30 J), mean age 59.5 years, 93% male, mean LVEF 0.32, 76% with coronary artery disease.
I
Intervention
Implantable cardioverter-defibrillator (ICD) implantation
C
Comparator
No ICD implantation
O
Outcome
Overall survival and survival free of arrhythmic deathhard clinical
In patients with high defibrillation thresholds, ICD implantation is associated with improved survival, although arrhythmic death remains a significant risk.
Limitations
- Retrospective analysis
- Selection bias (clinical selection decisions to implant or not implant an ICD may have differentiated patients destined to have better or worse outcomes)
Cite This Study
Epstein et al. (1992) studied this question.