• Nicolas Sadoul, Pascal Defaye, Elisabeth Mouton, Olivier Bizeau, Jean-Marc Dupuis, Hugues Blangy, Nicolas Delarche, Jean-Jacques Blanc, Arnaud Lazarus, and LEADER registry investigators.
• CHU, 54511 Nancy, France. Electronic address: n.sadoul@chu-nancy.fr.
• Arch Cardiovasc Dis. 2013 Nov 1;106(11):562-9.

BackgroundDefibrillation testing (DT) is usually performed during implantable cardioverter defibrillator (ICD) implantation.AimsWe conducted a multicentre prospective study to determine the DT procedures used in everyday practice, to compare the characteristics of patients with or without DT, and to compare severe adverse events in these two populations during implantation and follow-up.MethodsThe LEADER registry enrolled 904 patients included for primo-implantation of a single (n=261), dual (n=230) or triple (n=429) defibrillation system in 42 French centres.ResultsBaseline characteristics of patients (62.0 ± 13.5 years; 88% men; primary indication 62%) who underwent ventricular fibrillation (VF) induction (VF induction group, n=810) and those who did not (untested group, n=94, representing 10.4% of the entire study population) revealed that the untested group were older (P<0.01), had a lower left ventricular ejection fraction, a wider QRS complex and a higher New York Heart Association class and were more often implanted for primary prevention (P<0.001 for all). The main reason given for not performing ICD testing was poor haemodynamic condition (59/94). At 1 year, the cumulative survival rate was 95% in tested patients and 85% in untested patients (P<0.001), mainly because of heart failure deaths. There was one sudden cardiac death in the VF induction group and none in the untested group (P=1.000).ConclusionsIn this study, more than 10% of ICD patients were implanted without VF induction. Untested patients appeared to be sicker than tested patients, with a more severe long-term outcome, but without any difference in mortality due to arrhythmic events.Copyright © 2013 Elsevier Masson SAS. All rights reserved.

47 keywords...

hide…