Defibrillation threshold (DFT) testing to confirm an implantable cardioverter-defibrillator (ICD) could effectively terminate ventricular fibrillation is widely accepted as part of routine practice without much evidence of efficacy. However, advances in ICD technology and evidence of initial shock efficacy have called into question the importance of DFT testing. While testing rarely results in immediate complications, […]
Tag: ICD
ICD detection intervals: long or short?
Implantable cardioverter-defibrillators (ICDs) are now the standard of care in primary and secondary prevention of malignant arrhythmias, however with their increasing use it has been noted that ICD therapies – both appropriate and inappropriate – are associated with an increased risk of death and worsening of heart failure. The recent Multicenter Automatic Defibrillator Implantation Trial […]
Novel ICD programming reduces mortality
The implantable cardioverter-defibrillator (ICD) has consistently demonstrated benefit in reducing sudden cardiac death in patients at high risk of ventricular arrhythmias, but inappropriate ICD activations are a common occurrence with potential adverse effects on patient well-being and increased costs for health services. Strategies to reduce the frequency of inappropriate device activation without reducing efficacy in […]
Infective endocarditis caused by cardiac devices
The number of electronic cardiac devices, including pacemakers and cardioverter-defibrillators, being implanted each year is increasing. As a result, there has been a 210% increase in the incidence of device infection between 1993 and 2008 in the United States. Cardiac device infective endocarditis (CDIE) is significant in that it is associated with a higher mortality […]
Many US ICD implants not evidence based
For patients with severe systolic heart failure, several randomised trials have shown the ability of implantable cardioverter-defibrillator (ICD) devices to prevent sudden cardiac death. However, current US guidelines recommend against ICD insertion within 3 months of an initial heart-failure diagnosis, or within forty days of a myocardial infarction. […]
ICD implant risks highlight increasing sub-specialisation
Should cardiologists who are not electrophysiologists be inserting implantable cardioverter-defibrillators (ICDs)? Curtis et al. performed a retrospective cohort study of patients who had an ICD fitted between January 2006 and June 2007. Patients were grouped according to whom had implanted their device: electrophysiologists, nonelectrophysiologist cardiologists, thoracic surgeons, and other specialists. The main outcome measures examined […]