Prehospital discharge defibrillation testing in ICD recipients: A prospective study based on cost analysis

Prehospital discharge defibrillation testing is often performed to verify t he function of newly implanted cardioverter defibrillators (ICDs). To deter mine whether elimination of predischarge testing could reduce costs without placing patients at additional risk, 31 patients were randomized in this p rospective clinical evaluation to either receive or not receive a predischa rge ICD defibrillation test. Expenses associated with postimplant care was the primary endpoint. All patients underwent induction of ventricular fibri llation after 6 months to evaluate ICD function. The groups were well match ed in terms of patient characteristics, initial lead implant parameters, an d defibrillation thresholds. Elimination of prehospital discharge testing r esulted in a savings of $1,800/patient after 6 months, with no difference b etween groups in terms of ICD complication rates or unanticipated hospital admissions. Further studies are needed to better define the most appropriat e time to assess defibrillation thresholds in the first year after implanta tion.