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Effect of Electrophysiological Testing on Ejection Fraction During Cardioverter/Defibrillator Implantation

1988; Elsevier BV; Volume: 45; Issue: 3 Linguagem: Inglês

10.1016/s0003-4975(10)62471-x

1552-6259

Maria L. Antunes, Henry M. Spotnitz, Frank D. Livelli, Jonathan S. Steinberg, J. Thomas Bigger,

Cardiac Arrest and Resuscitation

To evaluate the effect of repeated induction of ventricular tachycardia or ventricular fibrillation, or both, in patients with poor left ventricular function, we performed intraoperative two-dimensional echocardiography in 6 patients undergoing implantation of the automatic implantable cardioverter/defibrillator.Changes in left ventricular ejection fraction in sinus rhythm were assessed before the first inducible ventricular arrhythmia and after a mean of 6 f 1.9 (SD) episodes of ventricular tachycardia or ventricular fibrillation.During the procedure no significant change in mean ejection fraction was observed (28 -C 14 versus 27 f 17%).Only 1 of the 6 patients studied had a change in ejection fraction greater than 3% (a decrease from 20 to 11%).In an overall clinical series of 38 primary implants or generator changes (including electrophysiological testing) in 29 patients, 1 patient recovered after postoperative inotropic support and l died of acute postoperative ischemic heart failure.We conclude that vefitricular arrhythmias induced during automatic implantable cardioverter/defibrillator implantation have no immediate deleterious effects on ejection fraction in most patients with compromised left ventricular function and without ongoing ischemia.