Keyser, Andreas and Hilker, Michael K. and Uecer, Ekrem and Wittmann, Sigrid and Schmid, Christof and Diez, Claudius (2013) Significance of intraoperative testing in right-sided implantable cardioverter-defibrillators. JOURNAL OF CARDIOTHORACIC SURGERY, 8: 77. ISSN 1749-8090,
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Background: Implantation of implantable cardioverter-defibrillators (ICD) from the left pectoral region is the standard therapeutical method. Increasing numbers of system revisions due to lead dysfunction and infections will consecutively increase the numbers of right-sided implantations. The reliability of devices implanted on the right pectoral side remains controversially discussed, and the question of testing these devices remains unanswered. Methods: In a prospectively designed study all 870 patients (60.0 +/- 14 years, 689 male) who were treated with a first ICD from July 2005 until May 2012 and tested intraoperatively according to the testing protocol were analyzed. The indication for implantation was primary prophylactic in 71.5%. Underlying diseases included ischemic cardiomyopathy (50%), dilative cardiomyopathy (37%), and others (13%). Mean ejection faction was 27 +/- 12%. Implantation site was right in 4.5% and left in 95.5%. Results: Five patients supplied with right-sided ICD (13%, p = 0.02 as compared to left-sided) failed initial intraoperative testing with 21 J. 3 patients were male. The age of the patients failing intraoperative testing with right-sided devices appeared higher than of patients with left-sided devices (p = 0.07). The ejection fraction was 28 +/- 8%. All patients reached a sufficient DFT <= 21 J after corrective procedures. Conclusion: Implantation of ICDs on the right side results in significantly higher failure rate of successful termination of intraoperatively induced ventricular fibrillation. The data of our study suggest the necessity of intraoperative ICD testing in right-sided implanted ICDs.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | COIL POSITION; THRESHOLD; THERAPY; TIME; EFFICACY; SHOCKS; LEADS; RISK; Implantable cardioverter defibrillator; Right-sided implantation; Intraoperative test |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie Medicine > Lehrstuhl für Innere Medizin I |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 17 Apr 2020 05:46 |
| Last Modified: | 17 Apr 2020 05:46 |
| URI: | https://pred.uni-regensburg.de/id/eprint/16828 |
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