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Rise in Chronic Defibrillation Energy Requirements Necessitating Implantable Defibrillator Lead System Revision
Author(s) -
DAOUD EMILE G.,
MAN K. CHING,
MORADY ERED,
STRIGKBERGER S. ADAM
Publication year - 1997
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1997.tb03890.x
Subject(s) - defibrillation , medicine , lead (geology) , implantable cardioverter defibrillator , cardiology , geology , geomorphology
The chronic defibrillation energy requirement (DER) is believed to remain clinically stable in patients with defibrillators. Six patients (two with an epicardial and four with a nonthoracotomy system) were identified with a rise in their chronic DER, which eliminated a 10‐J safety margin, thus necessitating a defibrillator lead system revision. The mean increase in DER was 14.7 ± 4 J and was discovered at a mean of 16.0 ± 18 months (range 2‐41) following implantation. Management included placement of a defibrillator with a biphasic waveform, placement of an additional defibrillation electrode, or both. At 2 months following revision of the defibrillation system, a 10‐J DER safety margin was present in each patient. In some patients, there is a progressive increase in the chronic DER with elimination of a 10‐J safety margin necessitating revision of the defibrillation system. Routine reevaluation of the chronic DER, therefore, is necessary to identify these patients.