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Mohammad Shenasa, N.A. Mark Estes, Gordon F. Tomaselli, Editors Despite the decline in mortality due to coronary artery disease over the last three decades, sudden cardiac death (SCD) remains a major health problem, claiming 250,000 to 300,000 lives annually in the United States. The annual incidence of SCD in Europe is similar to the United States, ranging from 50 to 100 per 100,000 in the general population. The overall survival rate remains poor, with only approximately 10% of individuals who experience a cardiac arrest surviving. Early defibrillation by an automated external defibrillator (AED) improves outcomes from cardiac arrest with survival rates to over 50% in some public locations. However, the majority of cardiac arrests occur in victim’s homes, where AEDs have not improved survival.
Based on these considerations, it is evident that identifying strategies for prediction and prevention of SCD represents an important public health priority. X Defibrillation testing (DFT) during implantable cardioverter-defibrillator (ICD) implantation is still considered standard of care in some, but in increasingly fewer centers. The goal is to ensure that the device system functions as intended by testing in the controlled laboratory setting. Although safe, complications can occur and DFT is associated with an increased procedural time and cost. Case 585e Forklift Manual more. DFT is useful in assessing device function when programming changes or patient characteristics raise concerns regarding ICD efficacy.
DFT remains standard of practice following implantation of subcutaneous ICDs and other specific circumstances. Implanting physicians should remain familiar with the process of DFT and situations where it is useful for individual patients. X Use of implantable cardioverter-defibrillators as a primary prevention therapy has been shown to reduce mortality in patients after cardiac arrest and also with left ventricular systolic dysfunction. Yet, inappropriate shocks are variably reported and associated with a reduction in quality of life. Inappropriate shocks are the result of environmental causes leading to electromagnetic interference and inappropriate sensing of external noise, device-related causes from inappropriate sensing of physiologic or pathologic signals, and supraventricular arrhythmias. Strategies to reduce inappropriate shocks include aggressive treatment of supraventricular tachycardia, changes in device programming including prolonged detection time, programming antitachycardic pacing and using discriminator algorithms, and cardiac rehabilitation.