Programming of implantable cardioverter-defibrillators on the basis of the upper limit of vulnerability

Charles D. Swerdlow, C. Thomas Peter, Robert M. Kass, Eli S. Gang, William J. Mandel, Chun Hwang, David J. Martin, Peng-Sheng Chen

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Background: A patient-specific measure of defibrillation efficacy that requires a minimum number of ventricular fibrillation (VF) episodes would be valuable for programming implantable cardioverter-defibrillators (ICDs). The upper limit of vulnerability (ULV) is the weakest shock strength at or above which VF is not induced when a stimulus is delivered during the vulnerable phase of the cardiac cycle. It correlates with the defibrillation threshold (DFT) and can be determined with a single episode of VF. The objective of this study was to test the hypothesis that ICDs programmed on the basis of the ULV convert spontaneous ICD-detected VF reliably. Methods and Results: We studied 100 consecutive patients at ICD implantation and during follow-up of 20±7 months. At implantation, the ULV and DFT were determined, and the ICD system was tested at a shock strength equal to the ULV+3 J. During follow- up, the strength of the first shock was programmed to the ULV+5 J for arrhythmias detected in the VF zone (cycle length

Original languageEnglish (US)
Pages (from-to)1497-1504
Number of pages8
JournalCirculation
Volume95
Issue number6
StatePublished - 1997
Externally publishedYes

Fingerprint

Implantable Defibrillators
Ventricular Fibrillation
Shock
Cardiac Arrhythmias

Keywords

  • defibrillation
  • heart-assist device
  • upper limit of vulnerability

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Swerdlow, C. D., Thomas Peter, C., Kass, R. M., Gang, E. S., Mandel, W. J., Hwang, C., ... Chen, P-S. (1997). Programming of implantable cardioverter-defibrillators on the basis of the upper limit of vulnerability. Circulation, 95(6), 1497-1504.

Programming of implantable cardioverter-defibrillators on the basis of the upper limit of vulnerability. / Swerdlow, Charles D.; Thomas Peter, C.; Kass, Robert M.; Gang, Eli S.; Mandel, William J.; Hwang, Chun; Martin, David J.; Chen, Peng-Sheng.

In: Circulation, Vol. 95, No. 6, 1997, p. 1497-1504.

Research output: Contribution to journalArticle

Swerdlow, CD, Thomas Peter, C, Kass, RM, Gang, ES, Mandel, WJ, Hwang, C, Martin, DJ & Chen, P-S 1997, 'Programming of implantable cardioverter-defibrillators on the basis of the upper limit of vulnerability', Circulation, vol. 95, no. 6, pp. 1497-1504.
Swerdlow CD, Thomas Peter C, Kass RM, Gang ES, Mandel WJ, Hwang C et al. Programming of implantable cardioverter-defibrillators on the basis of the upper limit of vulnerability. Circulation. 1997;95(6):1497-1504.
Swerdlow, Charles D. ; Thomas Peter, C. ; Kass, Robert M. ; Gang, Eli S. ; Mandel, William J. ; Hwang, Chun ; Martin, David J. ; Chen, Peng-Sheng. / Programming of implantable cardioverter-defibrillators on the basis of the upper limit of vulnerability. In: Circulation. 1997 ; Vol. 95, No. 6. pp. 1497-1504.
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