Predictors of high defibrillation threshold in patients with implantable cardioverter-defibillator using a transvenous dual-coil lead

Kazuya Mizukami, Hisashi Yokoshiki, Hirofumi Mitsuyama, Masaya Watanabe, Taro Tenma, Yoshiro Matsui, Hiroyuki Tsutsui

Research output: Contribution to journalArticle

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Abstract

Background: Defibrillation testing (DT) is considered a standard procedure during implantable cardioverter-defibrillator (ICD) implantation. However, little is known about the factors that are significantly related to patients with high defibrillation threshold (DFT) using the present triad system.

Methods and Results: We examined 286 consecutive patients who underwent ICD implantation with a transvenous dual-coil lead and DT from December 2000 to December 2011. We defined patients who required 25 J or more by the implanted device as the high DFT group, and those who required less than 25 J as the normal DFT group. For each patient, assessment parameters included underlying disease, comorbidities, NYHA functional class, drugs, and echocardiographic measures. The high DFT group consisted of 12 patients (4.2%). Multivariate analysis identified 3 independent predictors for high DFT: atrial fibrillation (odds ratio (OR) 4.85, 95% confidence interval (CI) 1.24–22.33, P=0.023), hypertension (OR 4.01, 95% CI 1.08–15.96, P=0.039), thickness of interventricular septum (IVS) >12 mm (OR 4.82, 95% CI 1.17–20.31, P=0.030).

Conclusions: Atrial fibrillation, hypertension and IVS hypertrophy were significantly associated with high DFT. Identification of such patients could help to lower the risk of complications with DT.

Original languageEnglish
Pages (from-to)78-84
Number of pages7
JournalCirculation Journal
Volume79
Issue number1
DOIs
Publication statusPublished - Dec 19 2014

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Implantable Defibrillators
Odds Ratio
Confidence Intervals
Atrial Fibrillation
Hypertension
Hypertrophy
Comorbidity
Multivariate Analysis
Equipment and Supplies
Pharmaceutical Preparations
Lead

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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Predictors of high defibrillation threshold in patients with implantable cardioverter-defibillator using a transvenous dual-coil lead. / Mizukami, Kazuya; Yokoshiki, Hisashi; Mitsuyama, Hirofumi; Watanabe, Masaya; Tenma, Taro; Matsui, Yoshiro; Tsutsui, Hiroyuki.

In: Circulation Journal, Vol. 79, No. 1, 19.12.2014, p. 78-84.

Research output: Contribution to journalArticle

Mizukami, Kazuya ; Yokoshiki, Hisashi ; Mitsuyama, Hirofumi ; Watanabe, Masaya ; Tenma, Taro ; Matsui, Yoshiro ; Tsutsui, Hiroyuki. / Predictors of high defibrillation threshold in patients with implantable cardioverter-defibillator using a transvenous dual-coil lead. In: Circulation Journal. 2014 ; Vol. 79, No. 1. pp. 78-84.
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