Risk Factors for Inadequate Defibrillation Safety Margins Vary With the Underlying Cardiac Disease: Implications for Selective Testing Strategies

Abstract

The present study on risk stratification for an inadequate DSM not only confirms the importance of making a distinction between IHD and non-IHD, but also shows that risk factors in an entire cohort (LV dilatation, age) may only apply to a subgroup (non-IHD). Appreciation of this concept could favorably affect current risk stratification. If confirmed, our approach may be used to optimize individualized testing decisions in an upcoming era of non-routine testing.

Ventricular Fibrillation Conversion Testing After Implantation of a Subcutaneous Implantable Cardioverter Defibrillator

“…The relatively small number of patients on amiodarone or sotalol may have reduced the power to detect an association between use of these drugs and an ISM. We did not have data on several potentially important predictors of an ISM, including electrode and pulse generator location, 1, 13 chest wall dimensions, cardiac dimensions, 21 and amount of subcutaneous fat below the electrode and pulse generator. 13 Although the inverse probability cohort appeared well balanced based on assessment of standardized differences, we cannot rule out the possibility of residual confounding, which would most likely lead to an underestimate of risk associated with VF conversion testing.…”