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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Impact of defibrillation test protocol and test repetition on the probability of meeting implant criteria.
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Impact of defibrillation test protocol and test repetition on the probability of meeting implant criteria.

机译：除颤测试方案和测试重复对满足植入标准的可能性的影响。

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BACKGROUND: Defibrillation testing is a common procedure at defibrillator implant, with the purpose to ensure that each patient receives a device-lead system with a sufficient shock efficacy. The objective of this paper was to study the influence of defibrillation test protocols on the probability of passing implant testing. METHODS: Defibrillation shock efficacy as a function of shock energy was modeled by a dose-response relationship estimated from the clinical data of the PainFREE Rx II study on 564 patients. A Monte Carlo method was used to simulate the outcomes of 12 commonly used defibrillation efficacy test protocols: four safety margin tests and eight protocols estimating the defibrillation threshold (DFT). RESULTS: The probabilities of failing 20-J and 25-J implant criteria for the different protocols ranged from 0.9% to 6.3% for 20 J and 0.3% to 3.4% for 25 J. Large variations in consecutively measured DFT values in the same patients were observed. Best results in the identification of high risk implant criterion of 20 J. The study also showed that the probability of patients inappropriately passing the implant criterion increased when the defibrillation test was repeated after initial failure. CONCLUSION: The defibrillation test protocol greatly influences the probability of meeting implant criterion. Therefore, these test protocols should be standardized. The model developed in this study, could be used to further understand their impact and to derive recommendations.
机译：背景：除颤测试是除颤器植入时的常见程序，目的是确保每位患者接受具有足够电击功效的设备导联系统。本文的目的是研究除颤测试方案对通过植入物测试的可能性的影响。方法：根据PainFREE Rx II研究对564例患者的临床数据估算的剂量反应关系，模拟除颤电击疗效与电击能量的函数关系。蒙特卡罗方法用于模拟12种常用除颤功效测试方案的结果：四种安全裕度测试和八种评估除颤阈值（DFT）的方案。结果：对于不同的方案，20-J和25-J植入标准失败的概率在20％的0.9％至6.3％和25 J的0.3％至3.4％范围内。同一患者连续测量的DFT值差异很大被观察。识别20 J的高风险植入物标准的最佳结果。研究还表明，在初次失败后重复进行除颤测试时，患者不当地通过植入物标准的可能性增加。结论：除颤测试方案极大地影响了满足植入标准的可能性。因此，这些测试协议应标准化。本研究开发的模型可用于进一步了解其影响并得出建议。

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