Defibrillation Safety Margin Testing in Patients With Congenital Heart Disease
| Autor: | Carolina A. Escudero, Yongfei Wang, Jonathan C. Hsu, Elizabeth A. Stephenson, Karl E. Minges, Jeptha P. Curtis, Jordan M. Prutkin |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Heart disease business.industry Defibrillation medicine.medical_treatment Odds ratio 030204 cardiovascular system & hematology Transposition of the great vessels medicine.disease Implantable cardioverter-defibrillator behavioral disciplines and activities Confidence interval 03 medical and health sciences 0302 clinical medicine Internal medicine mental disorders medicine In patient 030212 general & internal medicine business Tetralogy of Fallot |
| Zdroj: | JACC: Clinical Electrophysiology. 7:1145-1154 |
| ISSN: | 2405-500X |
| Popis: | Objectives This study analyzed the predictors of defibrillation safety margin (DSM) testing at the time of implantable cardioverter-defibrillator (ICD) insertion and factors associated with inadequate DSM in patients with congenital heart disease (CHD). Background There are few data about the prevalence and safety of DSM testing in those with CHD. Methods A retrospective analysis was performed of all patients with atrial or ventricular septal defect, tetralogy of Fallot, transposition of the great vessels, Ebstein anomaly, or common ventricle undergoing a transvenous ICD procedure in the National Cardiovascular Data Registry (NCDR) ICD Registry from April 2010 to March 2016, and DSM testing was assessed. Inadequate DSM was defined as a lowest successful energy tested Results Of all ICD recipients (N = 7,024), DSM testing was performed in 52.0% (n = 3,654). The mean lowest successful energy tested was 20.7 ± 7.3 J. Of those with DSM adequacy data available (n = 3,623), an inadequate DSM occurred in 13.8% (n = 501). After multivariable adjustment, DSM testing was not associated with in-hospital complications or death (odds ratio [OR]: 1.00; 95% confidence interval [CI]: 0.79 to 1.28) but was associated with lower odds of prolonged hospital stay (>3 days) (OR: 0.71; 95% CI: 0.60 to 0.84; p Conclusions DSM testing is being performed less frequently over time and seems safe in those with CHD. An inadequate DSM was not associated with worse in-hospital outcomes. |
| Databáze: | OpenAIRE |
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