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November 1, 1991Pacing and Clinical Electrophysiology

Is Defibrillation Testing Safe?

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Why the study?

Does repeated induction of ventricular fibrillation during ICD testing cause cumulative cerebral QEEG depression in patients undergoing ICD implantation?

Population

10 anesthetized patients undergoing implantable cardioverter defibrillator implantation and testing.

Design

Case_series

Follow-up

intraoperative

Authors

ISIgor SingerGoethe University FrankfurtJLJ van der LakenAmsterdam University Medical CentersHEHarvey L. EdmondsUniversity of Louisville

Discussion

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Implication

May warrant caution with >6 VF inductions during ICD testing; hypothesis-generating for cerebral safety thresholds.

Structured PICO

Does repeated induction of ventricular fibrillation during ICD testing cause cumulative cerebral QEEG depression in patients undergoing ICD implantation?

P
Population
10 anesthetized patients (5 males, 5 females, mean age 62 +/- 10 years) undergoing implantable cardioverter defibrillator (ICD) implantation and testing.
I
Intervention
Intraoperative ICD testing with repeated inductions of ventricular fibrillation (VF) and defibrillation attempts, monitored by quantitative electroencephalography (QEEG).
O
Outcome
Ischemic QEEG patterns (defined as a 3 standard deviation increase in absolute delta power persisting for >= 2.5 minutes) and QEEG slowing.surrogate

Repeated inductions of ventricular fibrillation during ICD testing (>6 episodes) are associated with cumulative cerebral QEEG depression, suggesting a need for an upper safe limit for defibrillation threshold testing.

Cite This Study

Singer et al. (1991) studied this question.

synapsesocial.com/papers/6a8ce49e748301e7973019e0https://doi.org/10.1111/j.1540-8159.1991.tb02787.x
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Defibrillation Testing and Early Neurologic Outcome2008 · 13 citations
  2. 2Clinical Evaluation of the Safety of Repetitive Intraoperative Defibrillation Threshold Testing1992 · 59 citations
  3. 3Assessment of Efficacy and Necessity of Routine Defibrillation Threshold Testing in Patients Undergoing Implantable Cardioverter-Defibrillator (ICD) Implantation2015 · 4 citations
  4. 4Single tests of implantable cardioverter defibrillators can be performed in selected patients at a low risk of neuronal damage2021
  5. 5Defibrillation Testing During ICD Implantation – Should we or Should we Not?2017 · 3 citations