TY - JOUR
T1 - Factors associated with successful implantation of nonthoracotomy defibrillation lead systems
AU - Schwartzman, David
AU - Concato, John
AU - Ren, Jian Fang
AU - Callans, David J.
AU - Gottlieb, Charles D.
AU - Preminger, Mark W.
AU - Marchlinski, Francis E.
N1 - Funding Information:
From aThe Clinical Electrophysiology Laboratory of the Philadelphia Heart Institute, bThe Clinical Epidemiology Unit, Yale University School of Medicine and The West Haven Veterans Affairs Medical Center. Supported in part by the Sidney Kimmel Research Center of the Philadel~ phia Heart Institute. Received for publication Sept. 15, 1995; accepted Oct. 16, 1995. Reprint requests: David Schwartzman, MD, Philadelphia Heart Institute, 39th and Market Streets, Philadelphia, PA 19104. Copyright © 1996 by Mosby-Year Book, Inc. 0002-8703/96/$5.00 + 0 4/1/71361
PY - 1996
Y1 - 1996
N2 - Two hundred forty-three consecutive patients underwent attempted implantation of nonthoracotomy defibrillation lead (NTL) systems. The importance of clinical and lead-related factors were analyzed regarding their relation with implantation failure caused by an unacceptably high defibrillation threshold (DFT). Overall, 33 (14%) of 243 patients failed NTL implantation. Patients undergoing attempted implantation of NTL systems with monophasic shock waveforms (monophasic group, n = 145) had an incidence of failed implantation of 22% (n = 32) versus an incidence of 1% (n = 1) among patients undergoing attempted implantation by using biphasic shock waveforms (biphasic group, n = 98; odds ratio, 26.9; p < 0.001). The incidence of success and simplicity of implantation of NTL systems was markedly improved in patients undergoing NTL implantation by using biphasic shock waveforms. Clinical factors could be used to stratify patients in the monophasic group for their risk of implantation failure. In the biphasic group, no clinical factor could be correlated with a low DFT with a fully endovascular system.
AB - Two hundred forty-three consecutive patients underwent attempted implantation of nonthoracotomy defibrillation lead (NTL) systems. The importance of clinical and lead-related factors were analyzed regarding their relation with implantation failure caused by an unacceptably high defibrillation threshold (DFT). Overall, 33 (14%) of 243 patients failed NTL implantation. Patients undergoing attempted implantation of NTL systems with monophasic shock waveforms (monophasic group, n = 145) had an incidence of failed implantation of 22% (n = 32) versus an incidence of 1% (n = 1) among patients undergoing attempted implantation by using biphasic shock waveforms (biphasic group, n = 98; odds ratio, 26.9; p < 0.001). The incidence of success and simplicity of implantation of NTL systems was markedly improved in patients undergoing NTL implantation by using biphasic shock waveforms. Clinical factors could be used to stratify patients in the monophasic group for their risk of implantation failure. In the biphasic group, no clinical factor could be correlated with a low DFT with a fully endovascular system.
UR - http://www.scopus.com/inward/record.url?scp=0029997959&partnerID=8YFLogxK
U2 - 10.1016/S0002-8703(96)90087-3
DO - 10.1016/S0002-8703(96)90087-3
M3 - Article
C2 - 8644591
AN - SCOPUS:0029997959
SN - 0002-8703
VL - 131
SP - 1127
EP - 1136
JO - American Heart Journal
JF - American Heart Journal
IS - 6
ER -