Is there a need for routine testing of ICD defibrillation capacity? Results from more than 1000 studies

Aims Benefits and complications of postoperative implant-Conclusions Our ex perience demonstrates that postoperative implantable cardioverter-defibrill ator tests are controversial operative tests of the defibrillation function of implantable matters. This study sought to assess the necessity of cardi overter-defibrillators rarely reveal dysfunctions. As defibrillation functi on tests after implantation. testing is unpleasant for the patient and not free of complications, rests might be restricted to those patients in whom Methods and Results We retrospectively analysed 1007 a dysfunction is suspe cted and to those patients in whom implantable cardioverter-defibrillator t ests in 587 systems class I or class III antiarrhythmic drugs have been add ed to and 556 patients. Nine hundred and thirty implantable the antiarrhyth mic drug regimen. cardioverter-defibrillator tests (89.4%) were routinely p erformed. Seventy-one tests (7%) were performed after a change in the antia rrhythmic drug regimen and six tests (0.60%) because of a suspected dysfunc tion of the implantable cardioverter-defibrillator. during routine tests. f our systems (0.4%) failed to defibrillate the patient. However. in all but one lest. abnormalities of the system had been observed before the test. Af ter the addition of antiarrhythmic drugs, two of 71 implantable cardioverte r-defibrillator systems (2.8%) failed to defibrillate the patient. One of s ix systems tested due to a suspected dysfunction failed to defibrillate the patient. During 16 tests (1.6%). complications occurred. Conclusions Our experience demonstrates that postoperative tests of the def ibrillation function of implantable cardioverter-defibrillators rarely reve al dysfunctions. As testing is unpleasant for the patient and not free of c omplications, tests might be restricted to those patients in whom a dysfunc tion is suspected and to those patients in whom class I or class III anntia rrhytmic drugs have been added to the antiarrhythmic drug regimen.