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Defibrillation Thresholds in Hypertrophic Cardiomyopathy
Author(s) -
QUIN ERNEST M.,
CUOCO FRANK A.,
FORCINA MATTHEW S.,
COKER JASON B.,
YOE ROBERT H.,
SPENCER WILLIAM H.,
FERNANDES VALERIAN L.,
NIELSEN CHRISTOPHER D.,
STURDIVANT J. LACY,
LEMAN ROBERT B.,
WHARTON J. MARCUS,
GOLD MICHAEL R.
Publication year - 2011
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2010.01943.x
Subject(s) - medicine , defibrillation threshold , hypertrophic cardiomyopathy , cardiology , defibrillation , implantable cardioverter defibrillator , ejection fraction , ventricular fibrillation , population , qrs complex , cardiomyopathy , heart failure , environmental health
Defibrillation Thresholds in Hypertrophic Cardiomyopathy . Background: Defibrillation threshold (DFT) testing is performed in part to ensure an adequate safety margin for the termination of spontaneous ventricular arrhythmias. Left ventricular mass is a predictor of high DFTs, so patients with hypertrophic cardiomyopathy (HCM) are often considered to be at risk for increased defibrillation energy requirements. However, there are little prospective data addressing this issue. Objective: To assess DFTs in patients with HCM and evaluate the clinical predictors of elevated DFTs. Methods: Eighty‐nine consecutive patients with HCM and 600 control patients with ischemic or nonischemic cardiomyopathy underwent a uniform modified step‐down DFT testing protocol. DFT was compared between the control and HCM populations. Predictors of elevated DFT were evaluated in the HCM group. Results: There was no difference in DFT between HCM and control groups (10.4 ± 5.8 J vs 11.2 ± 5.6 J, respectively). Among patients with HCM, clinical parameters such as left ventricular ejection fraction, interventricular septal thickness, left ventricular mass, and QRS duration were not predictive of an elevated DFT. Only 3 patients (3.4%) with HCM had a DFT >20 J. Conclusion: Patients with HCM do not have elevated DFTs as compared to more typical populations undergoing implantable cardioverter‐defibrillator implant; high‐energy devices or complex lead systems are not needed routinely in this population. (J Cardiovasc Electrophysiol, Vol. 22, pp. 569‐572 May 2011)