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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
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0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
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Effectiveness of defibrillation testing in patients undergoing subcutaneous ICD implantation.
Session:
Posters 3 - Écran 8 - Arritmologia
Speaker:
Gustavo Rodrigues
Congress:
CPC 2019
Topic:
C. Arrhythmias and Device Therapy
Theme:
09. Device Therapy
Subtheme:
09.2 Implantable Cardioverter / Defibrillator
Session Type:
Posters
FP Number:
---
Authors:
Gustavo Da Rocha Rodrigues; João Carmo; Diogo Cavaco; Pedro Lopes Do Carmo; Francisco Bello Morgado; Francisco Moscoso Costa; Maria Salomé Carvalho; Adriana Cavalcante; Pedro Adragão; Miguel Mendes
Abstract
<p><strong>Introduction </strong></p> <p>In contrast to transvenous implantable cardioverter-defibrillator (ICD), a defibrillation test (DFT) is systematically performed at implant of an S-ICD to confirm appropriate sensing and successful 65- J termination of induced ventricular fibrillation. The effectiveness of DFT is known to correlate with a correct positioning of the device.</p> <p>We aimed to access the effectiveness of DFT when following most recent positioning recommendations.</p> <p><strong>Methods and results</strong></p> <p>In a real world prospective registry of 94 patients who underwent S-ICD implant between 2011 and 2018, we analyzed the effectiveness of DFT, and the reasons for its failure. </p> <p>Most of the patients were male (78%), with a median age of 41 [24;56] years, 25% had atrial fibrillation (AF), 9% chronic kidney disease (GFR < 60 ml/min/1.73m<sup>2</sup>) and median body mass index was 24 [22;27]. S-ICD was implanted on primary prevention on most patients (69%), and hypertrophic cardiomyopathy was the main referring reason (table1).</p> <p>DFT was effective in 98% of the times with the first shock of 65 joules. In 2 of the patients with a higher BMI (32 and 33 kg/m<sup>2</sup>) a second shock with inverse polarity with a higher energy (80J) was delivered. Analyzing the thorax X-ray the misplacement of the coil was evident (leftwards in one case and too inferior in the other case). One of these device was explanted due to infection (with further re-implantation) and the other was left in place (without any shocks recorded on the following 4 years of follow-up).</p> <p><strong>Conclusion</strong></p> <p>In our population of patients with S-ICD, DFT was achieved in 100% of implants. In patients with troublesome features, like a higher BMI, special care is needed to guarantee a correct placement of the device.</p>
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