SEGUIMIENTO DE PACIENTES CON INDICACIÓN DE CARDIODESFIBRILADOR AUTOMATICO IMPLANTABLE SIN REALIZACION DEL TEST DE UMBRAL DE DESFIBRILACION

Abstract

The intraoperative threshold testing of the implantable cardioverter defibrillator (ICD) is considered a standard practice, but in some cases is contraindicated and may have potentially serious complications. We assessed the outcomes the patients with implantable cardioverter defibrillators implantation without performing defibrillation threshold test. Methods: 103 consecutive patients were included between January 2002 and July 2008, who received transvenous ICDs in our institutions, for the primary or secondary prevention. Evaluation of sensing parameters, pacing threshold and integrity of the system with subthreshold pulses testing was done at the moment of implant and during follow-up. Results: During a follow-up of 33,77 ± 21,44 (3-86) months, in 45 (43,7%) patients, 199 episodes were detected. 88 episodes did not need any therapy because they were selflimited, the antitachycardia pacing was Correspondencia: Francisco Femenia. Unidad de Arritmias. Departamento de Cardiologia. Hospital Espanol de Mendoza Av. San Martin 965. Godoy Cruz. Mendoza. Argentina. CP: 5501 Revista Iberoamericana de Arritmologia – ria Articulos originales DOI: 10.5031/v1i1.RIA1013 www.ria-online.com Sep 09 Vol. 1 No. 1 35 successful in 52 episodes, a shock of 20 was required in 5 episodes and 38 episodes were correctly sensed and they reverted with a first shock of > 30 J. There were 6,79% of inappropiate therapies and the mortality rate was 7,8%, none of the cases were due to sudden death or failure in the device. Conclusions: This consecutive series of patients with ICD without performing defibrillation threshold test, presented an important number of appropriate and effective therapies, showing the correct operation of the device.