Current Practice in Italy of VF Testing at Implant: What Do We Know and Where Do We Go From Here?

  • Michele Brignole
  • Giovanni Raciti
  • Maria Grazia Bongiorni
  • Giuseppe de Martino
  • Stefano Favale
  • Maurizio Gasparini
  • Raffaele Luise
  • Eraldo Occhetta
  • Alessandro Proclemer
Conference paper


The standardized requirements for cardioverter defibrillator (ICD) implantation, with or without cardiac resynchronization therapy (CRT), include defibrillation testing (DT), which consists of the induction and termination of ventricular fibrillation (VF). This procedure has been followed from the early days of ICD therapy in order to assess the reliability of an implanted ICD device and to measure the defibrillation threshold. Effective DT is considered mandatory in accordance with the rules of good clinical practice.


Ventricular Fibrillation Cardiac Resynchronization Therapy Systolic Heart Failure Induction Test Cardiac Resynchronization Therapy Device 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Alter P, Waldhans S, Plachta E et al (2005) Complications of implantable cardioverter defibrillator therapy in 440 consecutive patients. Pacing Clin Electrophysiol 28:926–932PubMedCrossRefGoogle Scholar
  2. 2.
    Russo AM, Sauer W, Gerstenfeld EP et al (2005) Defibrillation threshold testing: is it really necessary at the time of implantable cardioverter-defibrillator insertion? Heart Rhythm 2:456–461PubMedCrossRefGoogle Scholar
  3. 3.
    Pires LA, Johnson KM (2006) Intraoperative testing of the implantable cardioverter-defibrillator: how much is enough? J Cardiovasc Electrophysiol 17:140–145PubMedCrossRefGoogle Scholar
  4. 4.
    Strickberger SA, Klein GJ (2004) Is defibrillation testing required for defibrillator implantation? J Am Coll Cardiol 44:88–91PubMedCrossRefGoogle Scholar
  5. 5.
    Ezekowitz JA, Armstrong PW, McAlister FA (2003) Implantable cardioverter defibrillators in primary and secondary prevention: a systematic review of randomized, controlled trials. Ann Intern Med 138:445–452PubMedGoogle Scholar
  6. 6.
    Sweeney MO, Schoenfeld MH, Cannom DS (2005) Rules of evidence: CMS and primary prevention of sudden cardiac death in systolic heart failure. Pacing Clin Electrophysiol 28:81–88PubMedCrossRefGoogle Scholar
  7. 7.
    Proclemer A, Ghidina M, Cicuttini G et al (2006) Impact of the main implantable cardioverter-defibrillator trials for primary and secondary prevention in Italy. A survey of the national activity during the years 2001–2004. Pacing Clin Electrophysiol 29(Suppl 2):S20–S28PubMedCrossRefGoogle Scholar
  8. 8.
    Greenberg SM, Epstein AE, Deering T et al (2007) Differences in international ICD implantation rates: comparison of US and Italian practice. Pacing Clin Electrophysiol (in press)Google Scholar
  9. 9.
    Tokano T, Bach D, Chang J et al (1998) Effect of ventricular shock strength on cardiac hemodynamics. J Cardiovasc Electrophysiol 9:791–797PubMedCrossRefGoogle Scholar
  10. 10.
    Gilbert TB, Gold MR, Shorofsky SR et al (2002) Cardiovascular responses to repetitive defibrillation during implantable cardioverter-defibrillator testing. J Cardiothorac Vasc Anesth 16:180–185PubMedCrossRefGoogle Scholar
  11. 11.
    Gasparini M, Galimberti P, Regoli F et al (2005) Delayed defibrillation testing in patients implanted with biventricular ICD (CRT-D): a reliable and safe approach. J Cardiovasc Electrophysiol 16:1279–1283PubMedCrossRefGoogle Scholar
  12. 12.
    Fiek M, Zieg B, Matis T et al (2006) Analysis of the cause of death of ICD patients during long-term follow-up. Herzschrittmacherther Elektrophysiol 17:6–12PubMedCrossRefGoogle Scholar
  13. 13.
    Mitchell LB, Pineda EA, Titus JL et al (2002) Sudden death in patients with implantable cardioverter defibrillators: the importance of post-shock electromechanical dissociation. J Am Coll Cardiol 39:1323–1328PubMedCrossRefGoogle Scholar
  14. 14.
    Neuzner (2005) Is DFT testing still mandatory? Herz 30:601–606PubMedCrossRefGoogle Scholar
  15. 15.
    Favale S (2005) Test di defibrillazione durante l’impianto di defibrillatore automatico: è a ncora necessario? G Ital Aritmol Cardiostim 2:73–77Google Scholar

Copyright information

© Springer-Verlag Italia 2007

Authors and Affiliations

  • Michele Brignole
    • 1
  • Giovanni Raciti
    • 2
  • Maria Grazia Bongiorni
    • 3
  • Giuseppe de Martino
    • 4
  • Stefano Favale
    • 5
  • Maurizio Gasparini
    • 6
  • Raffaele Luise
    • 7
  • Eraldo Occhetta
    • 8
  • Alessandro Proclemer
    • 9
  1. 1.Department of CardiologyOspedali del TigullioLavagna (GE)
  2. 2.Boston Scientific ItalyMilan
  3. 3.Ospedale CisanelloPisa
  4. 4.Casa di Cura Santa MariaBari
  5. 5.Ospedale Consorziale PoliclinicoBari
  6. 6.Istituto Clinico HumanitasRozzano(MI)
  7. 7.Casa di Cura Villa Pini d’AbruzzoChieti
  8. 8.Ospedale Maggiore della CaritàNovara
  9. 9.Fondazione IRCABAzienda Ospedaliero-UniversitariaUdineItaly

Personalised recommendations