IngentaConnect Utility of Routine Follow-Up Defibrillator Threshold Testing in C...

Abstract:

DFT Follow-Up in Congenital Heart Disease and Pediatric Populations.

Introduction: Recent studies have suggested that routine defibrillation threshold (DFT) testing of implantable cardioverter defibrillators (ICDs) in adults may not be necessary. The congenital heart disease and pediatric populations are a unique group of ICD recipients having a higher incidence of lead failure. We investigated the utility of follow-up DFT testing in this population.

Methods and Results: The records of 155 ICD recipients at one center were retrospectively reviewed, and patients having one or more follow-up DFT tests were analyzed. The patients were divided into two groups. The “routine” group consisted of 58 follow-up DFT procedures in 46 patients, without known changes in ICD parameters. The “prompted” group consisted of 21 follow-up DFT procedures in 18 patients, motivated by clinical concerns about changes in ICD lead status. Of 58 “routine” DFTs performed at a mean postimplant duration of 32 ± 23 months (range 2–78), 7 (12%) had reprogramming, and 1 required a hardware change as a result of the testing. Of the 21 “prompted” DFTs performed, 7 required device reprogramming, and 3 required hardware upgrade. Overall, 19 (24%) of 79 procedures detected clinically significant changes, requiring reprogramming or ICD system revision. No complications were seen from follow-up DFT testing.

Conclusion: A high rate of abnormalities was found at follow-up DFT testing in this population, especially in the group of patients with clinically prompted testing. Clinically indicated DFT testing, as expected, has a high yield of important information on device function in congenital heart disease and pediatric populations.

(J Cardiovasc Electrophysiol, Vol. 16, pp. 69-73, January 2005)

Keywords: implantable defibrillator; pediatric devices; congenital heart disease

Document Type: Research article

DOI: 10.1046/j.1540-8167.2005.04528.x

Affiliations: 1: Department of Cardiology, Children's Hospital, Boston, and Department of Pediatrics, Harvard Medical School, Boston, Massachusetts, USA

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Utility of Routine Follow-Up Defibrillator Threshold Testing in Congenital Heart Disease and Pediatric Populations