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  • Title: [Clinical experience with a second-generation cardioverter-defibrillator].
    Author: Meyer BJ, Candinas R, Gloor HO, Bertel O, Amann FW, Turina MI.
    Journal: Schweiz Med Wochenschr; 1991 Nov 16; 121(46):1701-5. PubMed ID: 1957143.
    Abstract:
    Implantable cardioverter defibrillators (ICD's) are effective for reducing mortality in refractory malignant ventricular arrhythmias (MVA). Second generation ICD's (Telectronics Guardian 4202/4203) were implanted in 7 patients (all male, mean age 58.1 years) with ventricular fibrillation (VF) in 2, ventricular tachycardia (VT) in 1, and both VF and VT in 4. Underlying heart disease was coronary artery disease in 4 patients, and valvular heart disease, dilated cardiomyopathy and no obvious cause (documented primary VF, reproducible at electrophysiologic study) in 1 patient each. Mean ejection fraction was 40 +/- 14%. Mean defibrillation threshold of the two epicardial patches at implantation by means of median sternotomy was 18 +/- 9 joule, and patch impedance 35 +/- 7 ohms. Post defibrillation bradypacing via epicardial electrode was programmed in 5 patients (70%). Mean follow-up was 10.1 months (1-25 months). Successful defibrillation of 28 spontaneous VT/VF episodes was noted in 2 patients, while the other 5 have had no further episodes of MVA so far. One device was explanted following tissue necrosis at the battery site after a MVA-recurrence-free interval of 15 months. The reconfirmation algorithm prevented false shock delivery in 2 patients.
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