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The Effects of Shock from Defibrillation Threshold Testing on Cardiac Systolic and Diastolic Function
Author(s) -
KODANI TAKESHI,
MINE TAKANAO,
KISHIMA HIDEYUKI,
MASUYAMA TOHRU
Publication year - 2016
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/pace.12915
Subject(s) - medicine , cardiology , diastole , defibrillation , shock (circulatory) , defibrillation threshold , diastolic function , cardiac function curve , blood pressure , heart failure
Background Inappropriate implantable cardioverter defibrillator (ICD) shocks are associated with increased overall mortality. However, it remains unclear whether shocks from defibrillation threshold (DFT) testing directly impair cardiac function. Methods DFT testing was performed in 34 patients who underwent ICD/cardiac resynchronization therapy with a defibrillator implantation/generator exchange. Heart rate and cardiac function, including left ventricular (LV) systolic pressure, LV end‐diastolic pressure, peak positive and negative dp/dt ( + dp/dt and –dp/dt, respectively) of LV pressure, and the tau index, were assessed with a Mikro‐Cath™ diagnostic pressure catheter (CD Leycom, Zoetermeer, the Netherlands). These parameters were measured before and 1 minute, 3 minutes, 5 minutes, 10 minutes, and 15 minutes after DFT testing. Results Peak positive dp/dt increased over baseline at each interval (976 ± 229 mm Hg/s vs 1,039 ± 258, 1,049 ± 245, 1,042 ± 247, 1,037 ± 259, and 1,034 ± 254 mm Hg/s, respectively; P < 0.01). Furthermore, peak negative dp/dt (–1,140 ± 397 mm Hg/s vs –1,185 ± 447, 1,193 ± 435, –1,195 ± 434, –1,189 ± 449, and –1,186 ± 459 mm Hg/s, respectively; P < 0.01) and the tau index (65.1 ± 18.5 vs 62.5 ± 16.8*, 62.4 ± 15.9 ** , 63.0 ± 16.8*, and 62.8 ± 18.7*, respectively; *P < 0.05, ** P < 0.01) decreased compared to those at baseline at each interval. Conclusion Shock after DFT testing improved LV systolic and diastolic function immediately, especially in patients with preserved LV ejection fraction.