Long‐Term Stability of Defibrillation Thresholds with Intrapericardial Defibrillator Patches

ROSEMARY FRAME, RICHARD BRODMAN, SEYMOUR FURMAN, JAY GROSS, SOO G. KIM, KEVIN FERRICK, JAMES ROTH, INGRID HOLLINCER, JOHN D. FISHER

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

From March 1982 to May 1, 1992, 105 consecutive patients underwent initial implant of cardioverter defibrillators (ICD) at our institution. Twenty‐nine patients (23 male and 6 female, average ejection fraction 32.24%) with ICD systems implanted via thoracotomy and either intra‐ or extrapericardial patches, had one or more revisions including 56 generator changes or staged implant procedures, three patch revisions, one patch lead fracture without revision, and one sensing lead revision. The time between pulse generator revisions averaged 19.5 months. Initial defibrillation threshold mean was 12.8 joules (n = 25); at first revision, 14.46 joules (n = 29), (P = NS); by fifth revision, 15.0 joules (n = 2), (P = NS). One patch was noted to be crinkled at 70 months; one patch had migrated by 39 months, and two patch leads had fractured at the costal margin by 69 and 90 months. One patient with marginal defibrillation thresholds had an additional patch placed at revision to an upgraded ICD unit. Once acceptable defibrillation threshold (DFT) is obtained, the long‐term intrapericardial DFT remains stable unless a specific problem occurs. As a small, nonstatistically significant increase in DFT may occur, caution must be exercised in patients with marginal DFTs.

Original languageEnglish (US)
Pages (from-to)208-212
Number of pages5
JournalPacing and Clinical Electrophysiology
Volume16
Issue number1
DOIs
StatePublished - Jan 1993

Keywords

  • chronic defibrillation threshold
  • implantable cardioverter defibrillator

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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