[SCD-FORUM] EXPERTS ASK, EXPERTS ANSWER

[SCD Symposium]

Dr. Ariel Szyszko from Argentina asks

- Is it necessary to conduct a defibrillation threshold test as a  
routine in cardioverter defibrillator implants, or are there patients  
in whom the test's risk/benefit would not be justified?
Dr. Alfred Buxton from U.S.A. answers

- The risk of performing defibrillation threshold testing is  
extremely low, and we perform it routinely.  We defer performing the  
test in patients in atrial fibrillation who have not been adequately  
anticoagulated.  One situation in which we do consider deferring the  
test is in patients with nonischemic dilated cardiomyopathy in whom  
we have questions about their hemodynamic stability, but in general  
ICD implants should not be performed in unstable individuals.  We  
repeat the defibrillation test yearly in patients whose threshold at  
previous tests was >20 joules.  We also repast the defibrillation  
test in patients whose receiving new antiarrhythmic medication such  
as amiodarone,  that can elevate the DFT.

Alfred E. Buxton, M.D.
Ruth and Paul Levinger Professor of Medicine
Director, Division of Cardiology
Director, Arrhythmia Services and Electrophysiology Laboratory
Brown Medical School
Cardiology Division
2 Dudley Street, Suite 360
Providence, RI 02905
Alfred_Buxton at Brown.edu

--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee




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