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No benefit from defibrillation threshold testing in the SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial).

Publication ,  Journal Article
Blatt, JA; Poole, JE; Johnson, GW; Callans, DJ; Raitt, MH; Reddy, RK; Marchlinski, FE; Yee, R; Guarnieri, T; Talajic, M; Wilber, DJ; Chung, K ...
Published in: J Am Coll Cardiol
August 12, 2008

OBJECTIVES: This study investigated whether defibrillation threshold (DFT) testing during implantable cardioverter-defibrillator (ICD) implantation predicts clinical outcomes. BACKGROUND: Defibrillation testing is often performed during insertion of ICDs to confirm shock efficacy. There are no prospective data to suggest that this procedure improves outcomes when modern ICDs are implanted for primary prevention of sudden death. METHODS: The analysis included the 811 patients who were randomized to the ICD arm of the SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial) and had the device implanted. The DFT testing protocol in SCD-HeFT was designed to limit shock testing in a primary prevention heart failure population. RESULTS: Baseline DFT data were available for 717 patients (88.4%). All 717 patients had a DFT of < or =30 J, the maximum output of the device in this study. The DFT was < or =20 J in 97.8% of patients. There was no survival difference between patients with a lower DFT (< or =10 J, n = 547) and a higher DFT (>10 J, n = 170) (p = 0.41). First shock efficacy was 83.0% for the first clinical ventricular tachyarrhythmia event; there were no differences in shock efficacies when the cohort was subdivided by baseline DFT. CONCLUSIONS: Low baseline DFTs were obtained in patients with stable, optimally treated heart failure during ICD implantation for primary prevention of sudden death. First shock efficacy for ventricular tachyarrhythmias was high regardless of baseline DFT testing results. Baseline DFT testing did not predict long-term mortality or shock efficacy in this study.

Duke Scholars

Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

August 12, 2008

Volume

52

Issue

7

Start / End Page

551 / 556

Location

United States

Related Subject Headings

  • Ventricular Fibrillation
  • Stroke Volume
  • Predictive Value of Tests
  • Humans
  • Heart Failure
  • Electrophysiologic Techniques, Cardiac
  • Differential Threshold
  • Defibrillators, Implantable
  • Death, Sudden, Cardiac
  • Cardiovascular System & Hematology
 

Citation

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MLA
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Blatt, J. A., Poole, J. E., Johnson, G. W., Callans, D. J., Raitt, M. H., Reddy, R. K., … SCD-HeFT Investigators, . (2008). No benefit from defibrillation threshold testing in the SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial). J Am Coll Cardiol, 52(7), 551–556. https://doi.org/10.1016/j.jacc.2008.04.051
Blatt, Joseph A., Jeanne E. Poole, George W. Johnson, David J. Callans, Merritt H. Raitt, Ramakota K. Reddy, Francis E. Marchlinski, et al. “No benefit from defibrillation threshold testing in the SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial).J Am Coll Cardiol 52, no. 7 (August 12, 2008): 551–56. https://doi.org/10.1016/j.jacc.2008.04.051.
Blatt JA, Poole JE, Johnson GW, Callans DJ, Raitt MH, Reddy RK, et al. No benefit from defibrillation threshold testing in the SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial). J Am Coll Cardiol. 2008 Aug 12;52(7):551–6.
Blatt, Joseph A., et al. “No benefit from defibrillation threshold testing in the SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial).J Am Coll Cardiol, vol. 52, no. 7, Aug. 2008, pp. 551–56. Pubmed, doi:10.1016/j.jacc.2008.04.051.
Blatt JA, Poole JE, Johnson GW, Callans DJ, Raitt MH, Reddy RK, Marchlinski FE, Yee R, Guarnieri T, Talajic M, Wilber DJ, Anderson J, Chung K, Wong WS, Mark DB, Lee KL, Bardy GH, SCD-HeFT Investigators. No benefit from defibrillation threshold testing in the SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial). J Am Coll Cardiol. 2008 Aug 12;52(7):551–556.
Journal cover image

Published In

J Am Coll Cardiol

DOI

EISSN

1558-3597

Publication Date

August 12, 2008

Volume

52

Issue

7

Start / End Page

551 / 556

Location

United States

Related Subject Headings

  • Ventricular Fibrillation
  • Stroke Volume
  • Predictive Value of Tests
  • Humans
  • Heart Failure
  • Electrophysiologic Techniques, Cardiac
  • Differential Threshold
  • Defibrillators, Implantable
  • Death, Sudden, Cardiac
  • Cardiovascular System & Hematology