Key result
Repeated arrhythmia induction during ICD implantation shows no immediate adverse effect on LVEF.
Why the study?
The immediate effect of repeated induction of ventricular tachycardia or fibrillation on left ventricular ejection fraction during implantable cardioverter/defibrillator implantation in patients with poor LV function was unclear.
Does repeated induction of ventricular arrhythmias during AICD implantation reduce left ventricular ejection fraction in patients with poor LV function?
Observational (n=29)
Does repeated induction of ventricular arrhythmias during AICD implantation reduce left ventricular ejection fraction in patients with poor LV function?
Repeated induction of ventricular arrhythmias during AICD implantation does not cause immediate deleterious effects on ejection fraction in most patients with compromised left ventricular function.
Answers are grounded in this paper and cite their sources.
Induced VT/VF during defibrillator implantation showed no immediate LVEF change in most patients; leaves open confirmation in larger prospective cohorts.
To evaluate the effect of repeated induction of ventricular tachycardia or ventricular fibrillation, or both, in patients with poor left ventricular function, we performed intraoperative two-dimensional echocardiography in 6 patients undergoing implantation of the automatic implantable cardioverter/defibrillator. Changes in left ventricular ejection fraction in sinus rhythm were assessed before the first inducible ventricular arrhythmia and after a mean of 6 +/- 1.9 (SD) episodes of ventricular tachycardia or ventricular fibrillation. During the procedure no significant change in mean ejection fraction was observed (28 +/- 14 versus 27 +/- 17%). Only 1 of the 6 patients studied had a change in ejection fraction greater than 3% (a decrease from 20 to 11%). In an overall clinical series of 38 primary implants or generator changes (including electrophysiological testing) in 29 patients, 1 patient recovered after postoperative inotropic support and 1 died of acute postoperative ischemic heart failure. We conclude that ventricular arrhythmias induced during automatic implantable cardioverter/defibrillator implantation have no immediate deleterious effects on ejection fraction in most patients with compromised left ventricular function and without ongoing ischemia.
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Antunes et al. (1988) conducted an observational in Poor left ventricular function (n=29). Repeated induction of ventricular tachycardia or ventricular fibrillation vs. Baseline (before induction) was evaluated on Mean left ventricular ejection fraction. Repeated induction of ventricular arrhythmias during ICD implantation had no significant immediate effect on mean ejection fraction (28% before vs 27% after) in patients with poor LV function.
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