Defibrillation Threshold: Testing, Upper Limit of Vulnerability, and Methods for Reduction

Cardiac Electrophysiology Clinics

Volumn 3, Issue 3, 2011, Pages 473-492

  Hsia, Henry H ^a   Chia, Karin K M ^b   Evans, John C ^c  

^a STANFORD UNIVERSITY MEDICAL CENTER   (United States)

^b ROYAL BRISBANE AND WOMEN'S HOSPITAL   (Australia)

^c Pacific Heart Associates   (United States)

Author keywords

Defibrillation; Testing; Threshold; ULV

Indexed keywords

ACECAINIDE; AJMALINE; AMIODARONE; ATROPINE; BRETYLIUM; CARVEDILOL; CATECHOLAMINE; COCAINE; DILTIAZEM; DOFETILIDE; ENCAINIDE; FLECAINIDE; IBUTILIDE; ISOPRENALINE; LIDOCAINE; MEXILETINE; QUINIDINE; SILDENAFIL; SOTALOL; TEDISAMIL; VERAPAMIL;

CARDIOGENIC SHOCK; CARDIOVASCULAR PARAMETERS; DEFIBRILLATION; DEFIBRILLATION THRESHOLD; DEFIBRILLATOR; DISEASE DURATION; DOSE RESPONSE; ELECTRIC CURRENT; ELECTRIC POTENTIAL; ELECTRICITY; HEART ELECTROPHYSIOLOGY; HEART VENTRICLE FIBRILLATION; HUMAN; ISCHEMIA; METABOLIC PARAMETERS; PRIORITY JOURNAL; REVIEW; WAVEFORM;

EID: 80052289585     PISSN: 18779182     EISSN: 18779190     Source Type: Journal    
DOI: 10.1016/j.ccep.2011.05.012     Document Type: Review

References (82)

1. Davy J., Fain E., Dorian P., et al. The relationship between successful defibrillation and delivered energy in open-chest dogs: reappraisal of the "defibrillation threshold" concept. Am Heart J 1987, 113(1):77-84.
2. McDaniel W., Schuder J. The cardiac ventricular defibrillation threshold: inherent limitations in its application and interpretation. Med Instrum 1987, 21(3):170-176.
3. Singer I., Lang D. Defibrillation threshold: clinical utility and therapeutic implications. Pacing Clin Electrophysiol 1992, 15:932-949.
4. Singer I., Lang D. The defibrillation threshold. Implantable cardioverter defibrillator therapy 1996, 89-130. Kluwer Academic Publishers, Norwell (MA). M. Kroll, M. Lehmann (Eds.).
5. Zipes D., Fischer J., King R., et al. Termination of ventricular fibrillation in dogs by depolarizing a critical amount of myocardium. Am J Cardiol 1975, 36:37-44.
6. Winkle R., Mead R., Ruder M., et al. Effect of duration of ventricular fibrillation on defibrillation efficacy in humans. Circulation 1990, 81(5):1477-1481.
7. Jones J., Jones R. Improved defibrillator waveform safety factor with biphasic waveforms. Am J Physiol 1983, 245:H60-H65.
8. Dillon S. The electrophysiology of ventricular defibrillation: today and yesterday. Atrial and ventricular fibrillation: mechanisms and device therapy 1997, 113-144. Futura Publishing, Armonk (NY). M. Allessie, M. Fromer (Eds.).
9. Rattes M., Jones D., Sharma A., et al. Defibrillation threshold: a simple and quantitative estimate of the ability to defibrillate. Pacing Clin Electrophysiol 1987, 1(Pt 1):70-77.
10. Marchlinski F., Flores B., Miller J., et al. Relation of the intraoperative defibrillation threshold to successful postoperative defibrillation with an automatic implantable cardioverter defibrillator. Am J Cardiol 1988, 62:393-398.
11. Wiggers C. Defibrillation of the ventricles. Circ Res 1953, 1(3):191-199.
12. Wiggers C., Bell J., Paine M. Studies of ventricular fibrillation caused by electric shock: II. Cinematographic and electrocardiographic observations of the natural process in the dog's heart: its inhibition by potassium and the revival of coordinated beats by calcium. Ann Noninvasive Electrocardiol 2003, 18(3):252-261.
13. Witkowski F., Penkoske P., Plonsey R. Mechanism of cardiac defibrillation in open-chest dogs with unipolar DC-coupled simultaneous activation and shock potential recordings. Circulation 1990, 82(1):244-260.
14. Ideker R., Walcott G., Walcott K., et al. Mapping of ventricular fibrillation. Atrial and ventricular fibrillation: mechanisms and device therapy 1997, 63-79. Futura Publishing, Armonk (NY). M. Allessie, M. Fromer (Eds.).
15. Tung L., Cysyk J. Imaging fibrillation/defibrillation in a dish. J Electrocardiol 2007, 40:S62-S65.
16. Nanthakumar K., Jalife J., Massé S., et al. Optical mapping of Langendorff-perfused human hearts: establishing a model for the study of ventricular fibrillation in humans. Am J Physiol Heart Circ Physiol 2007, 293:H875-H880.
17. Dosdall D., Huang J., Ideker R. Mechanism of defibrillation. Ventricular arrhythmias and sudden cardiac death 2008, 277-288. Blackwell Futura, Malden (MA). P. Wang, H. Hsia, A. Al-Almad (Eds.).
18. Ideker R., Zhou X., Knisley S. Correlation among fibrillation, defibrillation and cardiac pacing. Pacing Clin Electrophysiol 1995, 18(Pt II):512-525.
19. Knisley S., Smith W., Ideker R. Effect of field stimulation on cellular repolarization in rabbit myocardium: implications for reentry induction. Circ Res 1992, 70(4):707-715.
20. Dillon S., Mehra R. Prolongation of ventricular refractoriness by defibrillation shocks may be due to additional depolarization of the action potential. J Cardiovasc Electrophysiol 1992, 3(5):442-456.
21. Dillon S. Synchronized repolarization after defibrillation shocks: a possible component of the defibrillation process demonstrated by optical recordings in rabbit heart. Circulation 1992, 85(5):1865-1878.
22. Kwaku K., Dillon S. Shock-induced depolarization of refractory myocardium prevents wave-front propagation in defibrillation. Circ Res 1996, 79(5):957-973.
23. Dillon S., Kwaku K. Progressive depolarization: a unified hypothesis for defibrillation and fibrillation induction by shocks. J Cardiovasc Electrophysiol 1998, 9(5):529-552.
24. Chen P., Wolf P., Ideker R. Mechanism of cardiac defibrillation: a different point of view. Circulation 1991, 84(2):913-919.
25. Wang N., Lee M., Ohara T., et al. Optical mapping of ventricular defibrillation in isolated swine right ventricles: demonstration of a post-shock isoelectric window after near-threshold defibrillation shocks. Circulation 2001, 104:227-233.
26. Link M., Wang P., Pandian N., et al. An experimental model of sudden death due to low-energy chest wall impact (commotio cordis). N Engl J Med 1998, 33(25):1805-1811.
27. Link M., Maron B., Wang P., et al. Upper and lower limits of vulnerability to sudden arrhythmic death with chest-wall impact (commotio cordis). J Am Coll Cardiol 2003, 41(1):99-104.
28. Katz A., Sweeney R., Gill R., et al. Relation of atrial refractoriness to upper and lower limits of vulnerability for atrial fibrillation/flutter following implantable ventricular defibrillator shocks. Circulation 1999, 100:1125-1130.
29. Frazier D., Wolf P., Wharton J., et al. Stimulus-induced critical point: mechanism for electrical initiation of reentry in normal canine myocardium. J Clin Invest 1989, 83(3):1039-1052.
30. Sweeney M., Sherfesee L., DeGroot P., et al. Differences in effects of electrical therapy type for ventricular arrhythmias on mortality in implantable cardioverter-defibrillator patients. Heart Rhythm 2010, 7(3):353-360.
31. Daubert J., Zareba W., Cannom D., et al. Inappropriate implantable cardioverter-defibrillator shocks in MADIT II: frequency, mechanisms, predictors, and survival impact. J Am Coll Cardiol 2008, 51(51):14.
32. Poole J., Johnson G., Hellkamp A., et al. Prognostic importance of defibrillator shocks in patients with heart failure. N Engl J Med 2008, 359:1009-1017.
33. Runsio M., Kallner A., Källner G., et al. Myocardial injury after electrical therapy for cardiac arrhythmias assessed by troponin-T release. Am J Cardiol 1997, 79:1241-1245.
34. Nikolski V., Efimov I. Electroporation of the heart. Europace 2005, 7:S146-S154.
35. Tereshchenko L., Faddis M., Fetics B., et al. Transient local injury current in right ventricular electrogram after implantable cardioverter-defibrillator shock predicts heart failure progression. J Am Coll Cardiol 2009, 54(9):822-828.
36. Mitchell L., Pineda E., Titus J., et al. Sudden death in patients with implantable cardioverter defibrillators: the importance of post-shock electromechanical dissociation. J Am Coll Cardiol 2002, 39(8):1323-1328.
37. Day J., Doshi R., Belott P., et al. Inductionless or limited shock testing is possible in most patients with implantable cardioverter-defibrillators/cardiac resynchronization therapy defibrillators: results of the multicenter ASSURE study (Arrhythmia Single Shock Defibrillation Threshold Testing Versus Upper Limit of Vulnerability: Risk Reduction Evaluation With Implantable Cardioverter-Defibrillator Implantations). Circulation 2007, 115:2382-2389.
38. Birgersdotter-Green U., Monir G., Ruetz L., et al. Automated vulnerability testing accurately identifies patients with inadequate defibrillation safety margin. Circulation 2010, 122:A20654. [abstract: 20654].
39. Chen P., Feld G., Kriett J., et al. Relation between upper limit of vulnerability and defibrillation threshold in humans. Circulation 1993, 88(1):186-192.
40. Hwang C., Swerdlow C., Kass R., et al. Upper limit of vulnerability reliably predicts the defibrillation threshold in humans. Circulation 1994, 90:2308-2314.
41. Swerdlow C., Ahern T., Kass R., et al. Upper limit of vulnerability is a good estimator of shock strength associated with 90% probability of successful defibrillation in humans with transvenous implantable cardioverter-defibrillators. J Am Coll Cardiol 1996, 27(5):1112-1118.
42. Swerdlow C., Davie S., Ahern T., et al. Comparative reproducibility of defibrillation threshold and upper limit of vulnerability. Pacing Clin Electrophysiol 1996, 19:2103-2111.
43. Martin D., Chen P., Hwang C., et al. Upper limit of vulnerability predicts chronic defibrillation threshold for transvenous implantable defibrillators. J Cardiovasc Electrophysiol 1997, 8(3):241-248.
44. Birgersdotter-Green U., Undesser K., Fujimura O., et al. Correlation of acute and chronic defibrillation threshold with upper limit of vulnerability determined in normal sinus rhythm. J Interv Card Electrophysiol 1999, 3:155-161.
45. Glikson M., Gurevitz O., Trusty J., et al. Upper limit of vulnerability determination during implantable cardioverter-defibrillator placement to minimize ventricular fibrillation inductions. Am J Cardiol 2004, 94(11):1445-1449.
46. Swerdlow C., Kass R., O'Connor M., et al. Effect of shock waveform on relationship between upper limit of vulnerability and defibrillation threshold. J Cardiovasc Electrophysiol 1998, 9(4):339-349.
47. Gurevitz O., Friedman P., Glikson M., et al. Discrepancies between the upper limit of vulnerability and defibrillation threshold: prevalence and clinical predictors. J Cardiovasc Electrophysiol 2003, 14(7):728-732.
48. Hsia H., Chonielewski L., Coss'u S., et al. A practical application of upper limit of vulnerability for predicting defibrillation threshold in man. Pacing Clin Electrophysiol 1996, 19:656. [Abstract].
49. Blanchard S., Ideker R., Cooper R., et al. The defibrillation waveform. Implantable cardioverter defibrillator therapy 1996, 147-161. Kluwer Academic Publishers, Norwell, (MA). M. Kroll, M. Lehmann (Eds.).
50. Swerdlow C., Fan W., Brewer J. Charge-burping theory correctly predicts optimal ratios of phase duration for biphasic defibrillation waveforms. Circulation 1996, 94(9):2278-2284.
51. Chapman P., Vetter J., Souza J., et al. Comparative efficacy of monophasic and biphasic truncated exponential shocks for non-thoracotomy internal defibrillation in dogs. J Am Coll Cardiol 1988, 12(3):739-745.
52. Bardy G., Ivey T., Allen M., et al. A prospective randomized evaluation of biphasic versus monophasic waveform pulses on defibrillation efficacy in humans. J Am Coll Cardiol 1989, 14(3):728-733.
53. Winkle R., Mead R., Ruder M., et al. Improved low energy defibrillation efficacy in man with the use of a biphasic truncated exponential waveform. Am Heart J 1989, 117:122-127.
54. Sims J., Miller A., Ujhelyi M. Disparate effects of biphasic and monophasic shocks on postshock refractory period dispersion. Am J Physiol 1998, 43:H1943-H1949.
55. Thakur R., Souza J., Chapman P., et al. Electrode polarity is an important determinant of defibrillation efficacy using a nonthoracotomy system. Pacing Clin Electrophysiol 1994, 17(5 Pt 1):919-923.
56. Shorofsky S., Gold M. Effects of waveform and polarity on defibrillation thresholds in humans using a transvenous lead system. Am J Cardiol 1996, 78(3):313-316.
57. Kroll M., Tchou P. Testing and programming of implantable defibrillator functions at implantation. Clinical cardiac pacing and defibrillation 2000, 540-561. WB Saunders, Philadelphia. K. Ellenbogen, G. Kay, B. Wilkoff (Eds.).
58. Rashba E., Shorofsky S., Peters R., et al. Effect of shock polarity on defibrillation thresholds with a hybrid patch-coil lead system. J Interv Card Electrophysiol 2003, 9(3):391-396.
59. Kroll M., Swerdlow C. Optimizing defibrillation waveforms for ICDs. J Interv Card Electrophysiol 2007, 18:247-263.
60. Hsia H., Kleiman R., Flores B., et al. Comparison of simultaneous versus sequential defibrillation pulsing techniques using a nonthoracotomy system. Pacing Clin Electrophysiol 1994, 17:1222-1230.
61. Cheng Y., Mowrey K., Van Wagoner D., et al. Virtual electrode-induced reexcitation: a mechanism of defibrillation. Circ Res 1999, 85(11):1056-1066.
62. Eason J., Trayanova N. Phase singularities and termination of spiral wave reentry. J Cardiovasc Electrophysiol 2002, 13(7):672-679.
63. Efimov I. Virtual electrodes in virtual reality of defibrillation. J Cardiovasc Electrophysiol 2002, 13(7):680-681.
64. Jung W., Manz M., Luderitz B. Effects of antiarrhythmic drugs on defibrillation threshold in patients with the implantable cardioverter defibrillator. Pacing Clin Electrophysiol 1992, 15(part 3):645-648.
65. Fain E., Lee J., Winkle R. Effects of acute intravenous and chronic oral amiodarone on defibrillation energy requirements. Am Heart J 1987, 114(1):8-17.
66. Jung W., Manz M., Pizzulli L., et al. Effects of chronic amiodarone therapy on defibrillation threshold. Am J Cardiol 1992, 70(11):1023-1027.
67. Pelosi F., Oral H., Kim M., et al. Effect of chronic amiodarone therapy on defibrillation energy requirements in humans. J Cardiovasc Electrophysiol 2000, 11(7):736-740.
68. Shinlapawittayatorn K., Sungnoon R., Chattipakorn S., et al. Effects of sildenafil citrate on defibrillation efficacy. J Cardiovasc Electrophysiol 2006, 17(3):292-295.
69. Russo A., Sauer W., Gerstenfeld E., et al. Defibrillation threshold testing: is it really necessary at the time of implantable cardioverter-defibrillator insertion?. Heart Rhythm 2005, 2(5):456-461.
70. Mainigi S., Cooper J., Russo A., et al. Elevated defibrillation thresholds in patients undergoing biventricular defibrillator implantation: incidence and predictors. Heart Rhythm 2006, 3(9):1010-1016.
71. Kroll M., Tchou P. Testing and programming of implantable defibrillator functions at implantation. Clinical cardiac pacing, defibrillation and resynchronization therapy 2007, 531-557. Saunders Elsevier, Philadelphia. K. Ellenbogen, G. Kay, C. Lau (Eds.).
72. Epstein A., Ellenbogen K., Kirk K., et al. Clinical characteristics and outcome of patients with high defibrillation thresholds: a multicenter study. Circulation 1992, 86(4):1206-1216.
73. Mainigi S., Callans D. How to manage the patient with a high defibrillation threshold. Heart Rhythm 2006, 3:492-495.
74. Kroll M., Schwab J. Achieving low defibrillation thresholds at implant: pharmacological influences, RV coil polarity and position, SVC coil usage and positioning, pulse width settings, and the azygous vein. Fundam Clin Pharmacol 2010, 5:561-573.
75. Rashba E., Bonner M., Wilson J., et al. Distal right ventricular coil position reduces defibrillation thresholds. J Cardiovasc Electrophysiol 2003, 14(10):1036-1040.
76. Cesario D., Bhargava M., Valderrábano M., et al. Azygos vein lead implantation: a novel adjunctive technique for implantable cardioverter defibrillator placement. J Cardiovasc Electrophysiol 2004, 15(7):780-783.
77. Kommuri N., Kollepara S., Saulitis E., et al. Azygos vein lead implantation for high defibrillation thresholds in implantable cardioverter defibrillator placement. Indian Pacing Electrophysiol J 2010, 10(1):49-54.
78. Cooper J., Latacha M., Soto G., et al. The Azygos defibrillator lead for elevated defibrillation thresholds: implant technique, lead stability, and patient series. Pacing Clin Electrophysiol 2008, 31(11):1405-1410.
79. Kroll M. A minimal model of the monophasic defibrillation pulse. Pacing Clin Electrophysiol 1993, 16:769-777.
80. Swerdlow C., Brewer J., Kass R., et al. Application of models of defibrillation to human defibrillation data: implications for optimizing implantable defibrillator capacitance. Circulation 1997, 96(9):2813-2822.
81. Mouchawar G., Kroll M., Val-Mejias J., et al. ICD waveform optimization: a randomized, prospective, pair-sampled multicenter study. Pacing Clin Electrophysiol 2000, 11:1992-1995.
82. Denman R., Umesan C., Martin P., et al. Does optimising an ICD's defibrillation waveform result in a lower defibrillation threshold (DFT)?. Heart Rhythm 2004, (1, 1, May Supplement):S275-S878.