Defibrillation threshold testing: Necessary but evil?

Abstract

Sudden cardiac death may be averted in patients with malignant ventricular tachyarrhythmias if they are protected with the automatic internal cardioverter defibrillator (AICD). A dramatic improvement in survival has been documented in survivors of out-of-hospital sustained ventricular tachycardia or ventricular fibrillation. Once a decision has been made to implant an AICD, special precautions are necessary to ensure its successful operation. To verify that the device will adequately sense, charge, and defibrillate, the electrode configuration and energy requirement must be tested at the time of original implantation. Defibrillation threshold testing (DFT) has been previously described.1-7 As AICD utilization becomes more widespread, this procedure wilI become more common as may potential complications. Consequently we reviewed the lessons from our initial experience.