No Benefit From Defibrillation Threshold Testing in the SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)

• Published in: Journal of the American College of Cardiology Vol. 52; no. 7; pp. 551 - 556
• Main Authors: Blatt, Joseph A., MD, Poole, Jeanne E., MD, Johnson, George W., BSEE, Callans, David J., MD, Raitt, Merritt H., MD, Reddy, Ramakota K., MD, Marchlinski, Francis E., MD, Yee, Raymond, MD, Guarnieri, Thomas, MD, Talajic, Mario, MD, Wilber, David J., MD, Anderson, Jill, RN, Chung, Kiyon, MD, MPH, Wong, Wai Shun, MD, Mark, Daniel B., MD, Lee, Kerry L., PhD, Bardy, Gust H., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 12.08.2008; Elsevier Limited
• Subjects: Amiodarone - therapeutic use; Anti-Arrhythmia Agents - therapeutic use; Cardiac arrhythmia; Cardiology; Cardiovascular; Death, Sudden, Cardiac - etiology; Death, Sudden, Cardiac - prevention & control; defibrillation threshold testing; Defibrillators; Defibrillators, Implantable; DFT testing; Differential Threshold; Electrodes; Electrophysiologic Techniques, Cardiac; Heart attacks; Heart failure; Heart Failure - complications; Heart Failure - drug therapy; Heart Failure - mortality; Heart Failure - therapy; Humans; implantable cardioverter-defibrillator; Internal Medicine; Mortality; Predictive Value of Tests; Stroke Volume; Studies; Success; sudden cardiac death; Ventricular Fibrillation - complications; Ventricular Fibrillation - prevention & control; defibrillation threshold; ventricular fibrillation; defibrillation threshold testing; DFT testing; EGM; sudden cardiac death; ICD; VF; electrogram; DFT; ventricular tachycardia; SCD; implantable cardioverter-defibrillator; VT
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2008.04.051

No Benefit From Defibrillation Threshold Testing in the SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial) Joseph A. Blatt, Jeanne E. Poole, George W. Johnson, David J. Callans, Merritt H. Raitt, Ramakota K. Reddy, Francis E. Marchlinski, Raymond Yee, Thomas Guarnieri, Mario Talajic, David J. Wilber, Jill Anderson, Kiyon Chung, Wai Shun Wong, Daniel B. Mark, Kerry L. Lee, Gust H. Bardy, for the SCD-HeFT Investigators Defibrillation testing is often performed during insertion of implantable cardioverter-defibrillators (ICDs) to confirm shock efficacy without good prospective data to suggest that this procedure improves outcomes. Our analysis included patients in the ICD arm of the SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial). We concluded that: 1) low baseline defibrillation thresholds (DFTs) were obtained in patients with optimally treated heart failure during ICD implantation for primary prevention of sudden death; 2) first shock efficacy for clinical ventricular tachyarrhythmias was high regardless of baseline DFT; and 3) baseline DFT did not predict long-term mortality or shock efficacy.