Key result
Initial phase polarity of RV+ significantly lowered the mean defibrillation threshold compared to RV- in the 7219C ICD group (6.6 vs 10.8 J; P=0.007), with a similar trend in the 7219D group.
Why the study?
Does changing the initial phase polarity to RV+ reduce the defibrillation threshold in patients receiving pectorally implanted biphasic ICDs?
Population
22 consecutive patients with VT-VF receiving pectorally implanted biphasic ICDs
Comparison
Initial phase polarity RV+ vs Initial phase polarity RV-
Design
RCT, tested in random order
Follow-up
at the time of implantation
Authors
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Supports RV+ initial polarity to lower DFT at pectoral biphasic ICD implant; extends waveform optimization evidence to modern devices.
RCT (n=22)
Random order
Does changing the initial phase polarity to RV+ reduce the defibrillation threshold in patients receiving pectorally implanted biphasic ICDs?
Absolute Event Rate: 6.6% vs 10.8%
p-value: p=0.007
Changing the polarity of the initial phase of a biphasic shock waveform to RV+ can significantly lower the defibrillation threshold during ICD implantation.
Keelan et al. (1997) conducted an RCT in Ventricular tachycardia or ventricular fibrillation (VT-VF) (n=22). Initial phase polarity RV+ (RV coil to active can/SVC) vs. Initial phase polarity RV- (active can/SVC coil +/- subcutaneous patch to RV coil) was evaluated on Mean defibrillation threshold (DFT) in the 7219C patient group (p=0.007). Initial phase polarity of RV+ significantly lowered the mean defibrillation threshold compared to RV- in the 7219C ICD group (6.6 vs 10.8 J; P=0.007), with a similar trend in the 7219D group.
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