Routine DFT testing in patients undergoing ICD implantation does not improve mortality: A systematic review and meta‐analysis
| Autor: | Paari Dominic, Brackett Alexandria, Munish Kannabhiran, Madan Acharya, Pratap Reddy, Nelson Telles, Usman Mustafa |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
inorganic chemicals
Clinical Review medicine.medical_specialty lcsh:Diseases of the circulatory (Cardiovascular) system implantable cardioverter defibrillator Defibrillation medicine.medical_treatment 030204 cardiovascular system & hematology DFT Defibrillation threshold 03 medical and health sciences 0302 clinical medicine Internal medicine medicine 030212 general & internal medicine business.industry ICD Odds ratio Implantable cardioverter-defibrillator medicine.disease mortality Icd implantation Standard error defibrillation testing lcsh:RC666-701 Meta-analysis Ventricular fibrillation Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Arrhythmia, Vol 34, Iss 6, Pp 598-606 (2018) Journal of Arrhythmia |
| ISSN: | 1880-4276 1883-2148 |
| Popis: | Defibrillation threshold (DFT) testing has been an integral part of implantable cardioverter‐defibrillator (ICD) implantation to confirm appropriate sensing of ventricular fibrillation and to establish an adequate safety margin for defibrillation. However, there is a lack of evidence regarding benefits of routine DFT testing. Therefore, we performed a meta‐analysis to assess its mortality benefit. We searched MEDLINE for studies comparing mortality outcomes in ICD recipients who underwent DFT testing to those who did not. For the second analysis, studies comparing outcomes in patients with high‐ vs low‐energy DFT were included. Odds ratio and standard errors were calculated, and inverse variance method in a random‐effect model was used to combine effect sizes. Fifteen studies with 10,975 subjects comparing outcomes in patients who underwent routine DFT testing during ICD implantation and those who did not were included. There was no difference in the group that did not undergo DFT testing with regards to all‐cause mortality (OR 0.935; CI 0.725‐1.207; P = 0.606), cardiac mortality (OR 0.709; CI 0.385‐1.307; P = 0.271), noncardiac mortality (OR 0.921; CI 0.701‐1.210; P = 0.554), and arrhythmic mortality (OR 1.152; CI 0.831‐1.596; P = 0.396). Percentage of successful appropriate first shocks among the two groups showed no difference. Five studies with 2278 subjects were included in the second analysis comparing patients with low DFT vs high DFT. Patients with high DFT had no significant increase in all‐cause mortality compared to patients with low DFT (OR 0.527; CI 0.034‐8.107; P = 0.646). Patients requiring higher DFT had no increased all‐cause mortality compared to patients with lower DFT. Routine DFT testing during ICD implantation does not confer any significant benefit. |
| Databáze: | OpenAIRE |
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