American Journal of Cardiology
Volume 83, Issue 5, Supplement 2 , Pages 34-39 , 11 March 1999

Safety and efficacy of implantable defibrillator therapy with programmed shock energy at twice the augmented step-down defibrillation threshold: results of the prospective, randomized, multicenter low-energy endotak trial

  • Joerg Neuzner, MD

      Affiliations

    • Kerckhoff Clinic, Bad Nauheim, Germany
    • Corresponding Author InformationAddress for reprints: Joerg Neuzner, MD, Department of Cardiology, Max Planck Institute for Physiological and Clinical Research, Kerckhoff Clinic, Benekestrasse 2–8, D-61231 Bad Nauheim, Germany
    • ,
  • Andreas Liebrich, MD

      Affiliations

    • University Hospital, Johannes Gutenberg University, Mainz, Germany
    • ,
  • Jens Jung, MD

      Affiliations

    • University Hospital, Saarland, Homburg-Saar, Germany
    • ,
  • Ewald Himmrich, MD

      Affiliations

    • University Hospital, Johannes Gutenberg University, Mainz, Germany
    • ,
  • Heinz F Pitschner, MD

      Affiliations

    • Kerckhoff Clinic, Bad Nauheim, Germany
    • ,
  • Joachim Winter, MD

      Affiliations

    • University Hospital, Heinrich Heine University, Düsseldorf, Germany
    • ,
  • Ernst G Vester, MD

      Affiliations

    • University Hospital, Heinrich Heine University, Düsseldorf, Germany
    • ,
  • Ulrich Michel (BSBME)

      Affiliations

    • Guidant Europe, Zaventem, Germany
    • ,
  • Seah Nisam (BSEE)

      Affiliations

    • Guidant Europe, Zaventem, Germany
    • ,
  • Armin Heisel, MD

      Affiliations

    • University Hospital, Saarland, Homburg-Saar, Germany

References 

  1. Wever EFD, Hauer RNW, Crijns HJGM, Van Capelle FJL, Bakker PFA, Robles de Medina EO. Dutch prospective randomized trial of implantable defibrillator as first-choice therapy versus conventional strategy. PACE Pacing Clin Electrophysiol. 1994;17:760–771
  2. The antiarrhythmic versus implantable defibrillators (AVID) investigators . A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. N Engl J Med. 1997;27:1576–1583
  3. Mirowsky M, Reid PR, Mower MM, Watkins L, Gott VL, Schauble JF, et al. Termination of malignant ventricular arrhythmias with an implanted automatic defibrillator in human beings. N Engl J Med. 1980;303:322–324
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  12. Winter J, Vester EG, Kuhls S, Kantarzis M, Perings C, Pauschinger M, et al. Defibrillation energy requirements with single endocardial (Endotak) lead. PACE. 1993;16:540–546
  13. Jones DL. The defibrillation threshold (a reliable method for rapid determination of defibrillation efficacy). In:  Estes NAM,  Manolis AS,  Wang PJ editor. Implantable Cardioverter-Defibrillator. New York: Marcel Dekker; 1994;p. 29–54
  14. Ideker RE, Tang ASL, Frazier DW, Shibata N, Chen P, Wharton J. Ventricular defibrillation (basic concepts). In:  El-Sherif N,  Samet P editor. Cardiac Pacing and Electrophysiology. Philadelphia: W.B. Saunders; 1991;p. 713–726
  15. Raitt MH, Dolack GL, Kudenchuk PJ, Poole JE, Bardy GH. Ventricular arrhythmias detected after transvenous defibrillator implantation in patients with a clinical history of only ventricular fibrillation. Circulation. 1995;91:1996–2001
  16. Active Can Investigators Bardy GH, Yee R, Jung W. Multicenter experience with a pectoral unipolar implantable cardioverter-defibrillator. J Am Coll Cardiol. 1996;28:400–510
  17. Winkle RA, Mead RH, Ruder MA, Gaugiani VA, Smith NA, Buch WS, et al. Long-term outcome in patients receiving an automatic implantable cardioverter-defibrillator. J Am Coll Cardiol. 1989;14:508–514
  18. Nisam S, Kaye SA, Mower MM, Hull M. AICD automatic implantable cardioverter-defibrillator clinical update (14 years experience in over 34,000 patients). PACE Pacing Clin Electrophysiol. 1995;16:142–147
  19. European Ventak P2 Investigator Group Neuzner J. Clinical experience with a new cardioverter-defibrillator, capable of biphasic waveform pulse and enhanced data storage (results of a prospective multicenter study). PACE Pacing Clin Electrophysiol. 1994;17:1243–1255
  20. Marchlinski FE, Flores B, Miller JM, Gottlieb CD, Hargrove WC. Relation of the intraoperative defibrillation threshold to successful postoperative defibrillation with an automatic implantable cardioverter-defibrillator. Am J Cardiol. 1988;62:393–398
  21. Mirowski M, Reid P, Winkle P, Mower MM, Watkins L, Stinson EB, et al. Mortality in patients with implanted automatic defibrillators. Ann Intern Med. 1983;98:585–588
  22. Pinski SL, Vanerio G, Castle LW, Morant VA, Simmons TW, Trohman RG, et al. Patients with high defibrillation threshold (clinical characteristics, management, and outcome). Am Heart J. 1991;122:89–95
  23. the high defibrillation threshold investigators Epstein AE, Ellenbogen KA, Kirk KA, Kay GN, Dailey SM, Plumb VJ. Clinical characteristics and outcome of patients with high defibrillation thresholds. A multicenter study. Circulation. 1992;86:1206–1216
  24. Strickberger AS, Man KC, Souza J, Zivin A, Weiss R, Knight BP, et al. A prospective evaulation of two defibrillation safety margin techniques in patients with low defibrillation energy requirements. J Cardiovasc Electrophysiol. 1998;9:41–46
  25. Vendetti FJ, Martin DT, Vassolas G, Bowen S. Rise in chronic defibrillation thresholds in nonthoracotomy implantable defibrillator. Circulation. 1994;89:216–223
  26. Hisa HH, Mitr RL, Flores BT, Marchlinski FE. Early postoperative increase in defibrillation threshold with nonthoracotomy systems in humans. PACE Pacing Clin Electrophysiol. 1994;17:1166–1173
  27. Schwarztman D, Callans DJ, Gottlieb CG, Heo J, Marchlinski FE. Early postoperative rise in defibrillation thresholds in patients with nonthoracotomy defibrillation lead systems (attenuation with biphasic shock waveforms). J Cardiovasc Electrophysiol. 1996;7:483–493
  28. Gold MR, Kavesh NG, Peters RW, Shorofsky SR. Biphasic waveform prevent the chronic rise in defibrillation threshold with a transvenous lead system. J Am Coll Cardiol. 1997;30:233–236

☆ This study was supported in part by Guidant/CPI Research, St. Paul, Minnesota.

PII: S0002-9149(99)00037-5

American Journal of Cardiology
Volume 83, Issue 5, Supplement 2 , Pages 34-39 , 11 March 1999

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