Impact of Induced Cardiac Arrest on Cognitive Function after Implantation of a Cardioverter-Defibrillator

Abstract

Induction of cardiac arrest during defibrillation threshold testing did not cause cognitive dysfunction 24 hours after implantation of the cardioverter-defibrillator.

2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter-defibrillator programming and testing

“…However, the clinical relevance of this transient finding is unclear because DT does not appear to cause cognitive dysfunction 24-48 hours following ICD implantation [200,201]. Although an increase in biochemical markers of myocardial injury can be observed during ICD implantation or after spontaneous clinical shocks, true intraoperative myocardial infarction (MI) is rare, even when extensive DT is performed [202][203][204][205].…”

Pre-discharge test may worsen cognitive functioning in patients with implantable cardioverter-defibrillator

“…There have been few publications regarding changes in the cognitive functioning of patients after the PT. They differ from our study in the number [7][8][9] or age of patients [7] and the methodology of psychological tests [7,8], and some of them assessed changes in cognitive functions induced by other factors [10][11][12].…”

“…Sometimes, to verify proper functioning of the ICD, a pre-discharge test (PT) is conducted [1,2]. While evaluation of the clinical benefits and risks of the PT has been the subject of many previous studies [3][4][5], the number of studies on the PT's possible impact on cognitive functioning is low. This effect is potentially possible due to PT-induced ventricular fibrillation and cardiac arrest, which cause short-term but evident brain ischaemia.…”

2015 HRS/EHRA/APHRS/SOLAECE expert consensus statement on optimal implantable cardioverter‐defibrillator programming and testing

“…However, EEG recovery occurs within less than 30 seconds, with a slightly longer time to the return of middle cerebral blood flow [197] , [198] , [199] . However, the clinical relevance of this transient finding is unclear because DT does not appear to cause cognitive dysfunction 24–48 hours following ICD implantation [200] , [201] . Although an increase in biochemical markers of myocardial injury can be observed during ICD implantation or after spontaneous clinical shocks, true intraoperative myocardial infarction (MI) is rare, even when extensive DT is performed [202] , [203] , [204] , [205] .…”