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At least 253 records · Page 14Linked to original sources
PubMed2006

How well are cardiopulmonary resuscitation and automated external defibrillator skills retained over time? Results from the Public Access Defibrillation (PAD) Trial.

BACKGROUND: The current standard for cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) retraining for laypersons is a four-hour course every two years. Others have documented substantial skill deterioration during this time period. OBJECTIVES: To evaluate 1) the retention of core CPR and AED skills among volunteer laypersons and 2) the time required to retrain laypersons to proficiency as a function of time since initial training. METHODS: This was an observational follow-up study evaluating CPR and AED skill retention and testing/retraining time up through 17 months after initial training. The study took place at 1,260 facilities recruited by 24 North American clinical research centers, and included 6,182 volunteer laypersons participating in the Public Access Defibrillation (PAD) Trial. Training to proficiency in either CPR only (N = 2,426) or CPR+AED (N = 3,756) was followed by testing/retraining provided three to 17 months later. Retraining was done in brief, one-on-one, individualized, interactive sessions. The outcome studied was instructors' global assessments of performance of CPR and AED skill adequacy, i.e., whether CPR actions would likely result in perfusion (yes/no) and whether AED actions would result in a shock through the heart (yes/no). RESULTS: For global CPR performance, 79%, 73%, and 71% of volunteers tested for the first time since initial training three to five, six to 11, and 12 to 17 months after initial training, respectively, were judged by their instructors as having adequate performance (p < 0.001, chi-square for linear trend). For global AED performance, 91%, 86%, and 84% of volunteers, respectively, were judged as having adequate performance (p < 0.001). The mean (+/- standard deviation) times required to test and retrain volunteers to proficiency were 5.7 (+/- 4.0) minutes for CPR skills and 7.7 (+/- 4.6) minutes for CPR+AED skills. CONCLUSIONS: Among PAD Trial volunteer laypersons participating in a simulated resuscitation, the proportions of volunteers judged by instructors to have adequate CPR and AED skills demonstrated small declines associated with longer intervals between initial training and subsequent testing. However, based on instructors' judgment, large majorities of volunteers still retained both CPR and AED core skills through 17 months after initial training. Furthermore, individual testing and retraining for CPR and AED skills were usually accomplished in less than 10 minutes per volunteer. Additional research is essential to identify training and evaluation techniques that predict adequate CPR and AED skill performance of laypersons when applied to an actual cardiac arrest.

Adult↗
PubMed1999

Effect of isoflurane on defibrillation threshold in biphasic active-can defibrillation systems.

In two patients receiving implantable cardioverter-defibrillators (ICD) for spontaneous and inducible ventricular tachyarrhythmias, the use of isoflurane appeared to significantly lower defibrillation thresholds (DFT) at implantation. In the first, at initial implantation and subsequent revision using isoflurane, adequate DFTs were verified by multiple tests. Post-implantation testing using midazolam and fentanyl revealed significantly higher DFTs, necessitating a third operation without isoflurane to obtain an adequate and subsequently verifiable DFT. During the second case, discontinuation of isoflurane intraoperatively resulted in a DFT rise within 25 minutes. In patients receiving general anesthesia for ICD implantation, this possible DFT effect of isoflurane should be recognized.

Anesthetics, Intravenous↗
PubMedDate not supplied

[Implantable defibrillators. Role of the defibrillator in treatment and prevention of sudden death].

PROVEN EFFICACY: Several studies have demonstrated that implantable defibrillators improve survival in patients with a very high risk of sudden death. INDICATIONS FOR PRIMARY PREVENTION: The most obvious indication is for young patients with severe recurrent rhythm disorders and generally good left ventricular function. However, most of the candidates have severe left ventricular dysfunction due to post infarction ischemia or dilated cardiomyopathy who develop syncopal or hemodynamically poorly tolerated ventricular tachycardia or who have survived a first episode of sudden death. PROPHYLACTIC INDICATIONS: Automatic defibrillation should be proposed for patients with factors of risk of sudden death such as left ventricular dysfunction or infarction sequelae.

Adult↗
PubMed2001

Five-year experience with implantation and follow-up of transvenous implantable cardioverter defibrillators: placing postimplant defibrillation threshold testing in perspective.

BACKGROUND: The rapid technological advancement in transvenous implantable cardioverter defibrillators (ICDs) has resulted in heterogeneous and often controversial approaches to follow-up procedures. The efficacy of postimplantation defibrillation threshold (DFT) testing with new-generation biphasic ICDs is unknown. OBJECTIVE: In this retrospective study, predischarge and postdischarge DFT protocols were compared to evaluate their safety and effect on adverse clinical events. METHODS: The study population consisted of 89 patients with 92 ICDs and 103 endovascular lead systems. Forty-four patients had DFT tests during implant and the predischarge period. Thirty patients had DFT tests during implant and the postdischarge period. Sixteen patients had only implant DFT data available. The follow-up period ranged from 3 days to 5.6 years. RESULTS: Ninety-nine percent of patients had successful implants. Postimplant DFT tests detected potential problems in only 1% of asymptomatic patients. Thirty-six percent of patients with normal predischarge DFT tests had adverse clinical events compared with 18% in the postdischarge group. Patients with postimplant DFTs > 25 joules (J) and safety margins > or = 10 J had a lower incidence of adverse clinical events (p = 0.03) compared with those with safety margins < 10 J. An 11% malfunction rate was observed in ICD leads during the follow-up period. CONCLUSIONS: DFT testing after implant is safe; however, routine postimplant DFT testing has limited value in assessing abnormalities in patients with the current generation of biphasic transvenous ICD devices. A 10-J safety margin was associated with a lower incidence of adverse clinical events in patients with DFTs > 25 J. Endovascular lead failure remains a significant problem with ICD systems requiring vigilant follow-up.

Aged↗
PubMed2005

[Spanish implantable cardioverter-defibrillator registry. First official report of the spanish society of cardiology working group on implantable cardioverter-defibrillators (2002-2004)].

OBJECTIVE: To report the 2002-2004 findings of the Spanish National Implantable Cardioverter-Defibrillator (ICD) Registry, established by the Spanish Society of Cardiology Working Group on Implantable Cardioverter-Defibrillators. MATERIAL AND METHOD: Data were collected prospectively after implantation using a single-page questionnaire returned to the Spanish Society of Cardiology. Participation was voluntary. RESULTS: The registry received reports on 925, 1,046 and 1414 implants, respectively, in the years 2002, 2003 and 2004. These figures represent 63%, 59% and 67.5%, respectively, of the total number of ICDs implanted. The reported implantation rates were 22, 24 and 33 per million, respectively, and the estimated total implantation rates were 35, 41 and 49, per million, respectively. The number of device replacements increased from 20% to 30% between 2002 and 2004. The majority of patients were male, their median age was 66 years, they had severe or moderate left ventricular dysfunction, and they were in functional class I or II. The most common underlying heart disease was ischemic heart disease. The main indications for an ICD were sustained monomorphic ventricular tachycardia and aborted sudden cardiac death, though the number of prophylactic indications has increased. Most ICDs were implanted in an electrophysiology laboratory by a cardiac electrophysiologist. The implantation rates of dual-chamber ICDs and ICDs with cardiac resynchronization therapy were approximately 30% and 15%, respectively. Very few complications occurred during implantation. CONCLUSIONS: The Spanish National ICD Registry contains a representative sample of ICD implantations performed in the country. The registry is one of the largest reported.

Adolescent↗
PubMed2006

[Automatic external defibrillator (AED) and public access defibrillation (PAD)].

Sudden death is a major public hazard and is usually caused by ventricular fibrillation (VF). Although in the majority of cases witnesses are to be found, resuscitation efforts are begun only in a minority of victims. The only treatment for VF is electrical shock and the time from collapse to resuscitation and defibrillation determine prognosis. Automated external defibrillator (AED) is a new device capable of effectively identifying and treating VF. It is unique in the sense that it can be operated by a non-medical operator following short training. Recent evidence of the survival benefit of AED utility is emerging. During the coming years, AEDs will be introduced to a growing number of hospitals and public places. This review summarizes the rationale for use, advantages, and disadvantages as well as the current status of AEDs and recommendations for placement of AEDs in Israel.

Arrhythmias, Cardiac↗
PubMed1998

Measurement of the upper limit of vulnerability during defibrillator implantation can substitute defibrillation threshold measurement.

We investigated whether defibrillation thresholds (DFTs) could be measured more safely during defibrillator implantation by measuring the upper limit of vulnerability (ULV) without using any special equipment. Nonthoracotomy ICD implantation with endocardial leads was performed in 13 patients, and through the use of the ICD function itself, ULV and DFT were measured using the delayed four-episode up-down algorithm. Myocardial injures caused by high-energy current were assessed by electrocardiograms and serial CPK-MB. ULV was confirmed in all cases, and it strongly correlated with DFT. The average ULV was 5.9 +/- 3.3 J, while the average DFT was 7.9 +/- 4.3 J (r = 0.89, p < 0.0001, DFT = 1.20+1.14x ULV). The average ULV was thus significantly lower (p < 0.01). Although six patients were on amiodarone therapy, the strong correlation between ULV and DFT was also maintained (r = 0.97), p < 0.01) in these patients. In all cases, the CPK-MB failed to increase, and no myocardial injuries were detectable on electrocardiograms. We confirmed that ULV could be easily and safety measured during ICD implantation, and that ULV could be used instead of DFT.

Adult↗
PubMed1989

Transthoracic defibrillation threshold of sine and trapezoidal waveforms in defibrillation.

The transthoracic defibrillation threshold of trapezoidal (2.5-, 5-, 10-, 15-, 20-, 40-, and 55-msec duration) and damped sine waveforms were established in groups of anesthetized greyhounds. Of the seven trapezoidal waveforms, the threshold current was lowest for the 20-msec pulse but was not significantly different for the 5-20-msec pulses (p greater than 0.05). The threshold delivered energy was not significantly different for the 2.5-20-msec waveforms. The 40- and 55-msec pulses had significantly greater delivered energies than the shorter pulses (p less than 0.01). The transthoracic defibrillation threshold of two trapezoidal (5- and 20-msec) and three damped sine waves (Lown, Edmark, and Belfast) showed that the threshold transthoracic current and energy were not significantly different for the 5-msec trapezoid and three sine waves (p greater than 0.05). The threshold transthoracic energy for the 20-msec trapezoid was significantly greater than that of the four other waveforms. The threshold current for the 20-msec trapezoid was significantly less than that of the Belfast and Edmark waveforms only. Thus, none of the three damped sine waveforms was superior, with the 5-msec trapezoid producing similar results. Although the 20-msec trapezoid had the lowest threshold current, it had the highest delivery energy.

Animals↗
PubMedDate not supplied

Efficacy of out of hospital defibrillation by ambulance technicians using automated external defibrillators. The Heartstart Scotland Project.

During the Heartstart Scotland project all 407 ambulances in Scotland were equipped with automated external defibrillators (AEDs). All cases of chest pain or collapse aged over 10 years were monitored and multiple 3-s rhythm strips recorded in a solid state memory module. A shockable rhythm was defined as an organised rhythm of > or = 180 beats/min or a disorganised rhythm of > or = 100 beats/min and amplitude > 0.1 mV. We analysed all the stored rhythm strips in two patient populations to determine the ability of the AED and ambulance crews to detect a shockable rhythm and to initiate appropriate defibrillation. The first population comprised 493 patients, all of whom had received shocks. A total of 4741 rhythm strips were analysed, of which 1461 were true positives, 33 false positives, 3161 true negatives and 86 false negatives. Overall sensitivity of the AED was 94.4% and specificity 99.0%. The second population comprised a random sample of 200 shocked and 200 non-shocked arrests. The combined group contained 4154 rhythm strips of which 562 were true positives, 12 false positives, 3460 true negatives and 120 false negatives. Overall sensitivity of the system (AED+crew) was 82.4% and specificity 99.7%. However, only 66 of the 120 false negatives were attributable to the AED giving a sensitivity of 90.3% for the AED. The sensitivity of the AED is dependent on the prevalence of shockable rhythms, but will be within the range 90.3-94.4% for most emergency medical services. We conclude that early management of potentially lethal arrhythmias by ambulance technicians using AEDs is practical with acceptable sensitivity and specificity.

Ambulances↗
PubMed1991

Effects of pacing rate and timing of defibrillation shock on the relation between the defibrillation threshold and the upper limit of vulnerability in open chest dogs.

To test the relation between the defibrillation threshold and the upper limit of vulnerability, the shock strength associated with 50% probability of successful defibrillation (DFT50) and that associated with 50% probability of reaching the upper limit of vulnerability (ULV50) were determined in 20 open chest dogs with use of the delayed up-down method, with pacing drive cycle lengths of 150 to 500 ms and either single 6-ms shocks (10 dogs) or 12-ms biphasic shocks (10 dogs) given at the mid-upslope, peak and mid-downslope of the T wave of electrocardiographic lead II. The shocks were given by means of a patch-patch configuration on the anterior and posterior surfaces of the heart, which was paced from a stimulating electrode attached to the left ventricular apex. Analysis of variance showed no statistically significant differences in ULV50 as determined with different pacing cycle lengths. For monophasic shocks, DFT50 (331 +/- 66 V or 5.8 +/- 2.7 J) was not significantly different from ULV50 determined at the mid-upslope of the T wave (318 +/- 64 V or 5 +/- 2 J). The correlation coefficients between the two values were 0.74 (p = 0.014) for voltage and 0.67 (p = 0.034) for energy. In contrast, DFT50 was significantly higher than ULV50 as determined at the peak of the T wave (219 +/- 43 V or 2.3 +/- 1 J) and mid-downslope of the T wave (200 +/- 38 V or 1.9 +/- 0.9 J). In three dogs, ventricular fibrillation could not be induced at the mid-downslope of the T wave with any baseline pacing (Si) cycle length.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1993

Defibrillation shocks produce different effects on Purkinje fibers and ventricular muscle: implications for successful defibrillation, refibrillation and postshock arrhythmia.

OBJECTIVES: To understand the mechanisms of postdefibrillation arrhythmias and failed defibrillation, we studied the cellular effects of high voltage shocks on different cardiomyocytes in the dog. BACKGROUND: The causes of postdefibrillation arrhythmias and unsuccessful defibrillation are not clear. METHODS: High voltage shocks with voltage differentials of 9.3 to 97.6 V/cm were delivered to isolated canine papillary muscles with attached Purkinje fibers. Transmembrane potentials were recorded simultaneously from the Purkinje fiber and the ventricular muscle using standard microelectrode techniques. RESULTS: After delivery of high voltage shocks, significant depolarization and rapid firing were observed in Purkinje fibers. The maximal rate of the rapid firing in the Purkinje fibers correlated with shock intensity (r = 0.69, p < 0.05). In contrast, in ventricular muscle, only slight depolarization and a transient refractory state were observed after the shock. The incidence of the refractory state was correlated with both the shock intensity and the rate of the rapid firing in the Purkinje fiber (r = 0.89 and 0.74, p < 0.01 and 0.05, respectively). Propranolol at a concentration sufficient for complete beta-blockade (1 mg/liter) did not change the tissue response to shocks but suppressed or abolished the shock-induced rapid firing of Purkinje fibers at a higher concentration (3 mg/liter). Blockade of the slow calcium channel with verapamil (400 micrograms/dl) did not alter the responsiveness of the preparation to shocks. CONCLUSION: These results indicate that high voltage shocks induce different responses in Purkinje fibers and ventricular muscle. The shock-induced rapid firing in the Purkinje fiber may contribute to postshock arrhythmias and possibly refibrillation in some cases. The shock-induced transient refractory state in the ventricular muscle may prevent the ventricle from responding to the rapid firing and thus may decrease the incidence of postshock arrhythmias.

Action Potentials↗
PubMed2001

European Resuscitation Council Guidelines 2000 for Automated External Defibrillation. A statement from the Basic Life Support and Automated External Defibrillation Working Group(1) and approved by the Executive Committee of the European Resuscitation Council.

The European Resuscitation Council (ERC) last issued guidelines for Automated External Defibrillators (AEDs) in 1998 [1]. The American Heart Association, together with representatives from the International Liaison Committee on Resuscitation (ILCOR), then undertook a series of evidence-based evaluations of the science of resuscitation [2] which culminated in the publication of "Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care" in August 2000 [3,4]. The Basic Life Support and Automated External Defibrillation Working Group (BLS&AED Working Group of the ERC) has considered this document and has recommended changes in the ERC AED guidelines. These are presented in this paper.

Algorithms↗
PubMed2005

Prospective assessment of integrating the existing emergency medical system with automated external defibrillators fully operated by volunteers and laypersons for out-of-hospital cardiac arrest: the Brescia Early Defibrillation Study (BEDS).

AIMS: There are few data on the outcomes of cardiac arrest (CA) victims when the defibrillation capability of broad rural and urban territories is fully operated by volunteers and laypersons. METHODS AND RESULTS: In this study, we investigated whether a programme based on diffuse deployment of automated external defibrillators (AEDs) operated by 2186 trained volunteers and laypersons across the County of Brescia, Italy (area: 4826 km(2); population: 1 112 628), would safely and effectively impact the current survival among victims of out-of-hospital CA. Forty-nine AEDs were added to the former emergency medical system that uses manual EDs in the emergency department of 10 county hospitals and in five medically equipped ambulances. The primary endpoint was survival free of neurological impairment at 1-year follow-up. Data were analysed in 692 victims before and in 702 victims after the deployment of the AEDs. Survival increased from 0.9% (95% CI 0.4-1.8%) in the historical cohort to 3.0% (95% CI 1.7-4.3%) (P=0.0015), despite similar intervals from dispatch to arrival at the site of collapse [median (quartile range): 7 (4) min vs. 6 (6) min]. Increase of survival was noted both in the urban [from 1.4% (95% CI 0.4-3.4 %) to 4.0% (95% CI 2.0-6.9 %), P=0.024] and in the rural territory [from 0.5% (95% CI 0.1-1.6%) to 2.5% (95% CI 1.3-4.2%), P=0.013]. The additional costs per quality-adjusted life year saved amounted to euro39 388 (95% CI euro16 731-49 329) during the start-up phase of the study and to euro23 661 (95% CI euro10 327-35 528) at steady state. CONCLUSION: Diffuse implementation of AEDs fully operated by trained volunteers and laypersons within a broad and unselected environment proved safe and was associated with a significantly higher long-term survival of CA victims.

Automation↗
PubMed1991

Differences in the pathological changes in dogs' hearts after defibrillation with extrapericardial paddles and implanted defibrillator electrodes.

A comparison was made between the pathological changes in the myocardium of eight dogs, each receiving about 90 joules of energy in a series of defibrillation discharges, delivered either between paddles placed against the pericardium (3 dogs) or between implanted Telectronics 040-105 defibrillation patch electrodes (5 dogs). The changes in the myocardium were most pronounced where the paddles had been applied to the pericardium. There was transmural damage beneath the left and right paddle positions and in the surrounding tissues. Extensive subepicardial and subendocardial myocyte damage was obvious histologically in the right ventricle of one of the patch dogs and in all of the paddle dogs. The percentage of damaged myocardial mass, both right ventricular and total involvement, was higher in the three paddle dogs compared with the five patch dogs. There was septal damage in the heart of one paddle dog. Necrosis of the right ventricular wall was observed in three of the patch dogs and in all the three paddle dogs. Scattered necrotic myocytes and some patches of mild necrosis up to 1-mm deep were observed in the left ventricle of the patch dogs (severity score 1-3). The necrosis was more extensive in the paddle dogs, ranging from mild necrosis less than 1-mm deep to marked necrosis incorporating half-to-whole ventricular wall thickness (severity score 3-5).

Animals↗
PubMed2001

Limited response to cardiac arrest by police equipped with automated external defibrillators: lack of survival benefit in suburban and rural Indiana--the police as responder automated defibrillation evaluation (PARADE).

OBJECTIVE: To assess the out-of-hospital cardiac arrest (OHCA) survival advantage after providing police with automated external defibrillators (AEDs) in rural and suburban Indiana. METHODS: An observational evaluation was conducted in six Indiana counties (population: 464,741) before (retrospective) and after (prospective) training and equipping police with AEDs. The primary outcome evaluated was survival to hospital discharge for all cases of ventricular tachycardia/ventricular fibrillation (VT/VF) OHCA. Other factors evaluated include age, gender, race, arrest location, witnessed arrest, bystander cardiopulmonary resuscitation, response intervals, and survival to discharge for all OHCAs. Results are reported using chi-square, Student's t-test, and logistic regression. RESULTS: Police were equipped with 112 AEDs, increasing total defibrillator capability by 43.2%. During the study period, AED-equipped police responded prior to emergency medical services (EMS) in 26 of 388 cases (6.7%). The time intervals from 911 call-to-scene and 911 call-to-shock were shortened by 1.6 minutes (95% confidence interval [95% CI] = 0.0 to 3.1, p = 0.05) and 4.8 minutes (95% CI = 1.3 to 8.3, p = 0.008), respectively, with police response as compared with EMS response. Survival to hospital discharge for VT/VF OHCA was 15.0% (3/20) in cases in which police responded first and 10.0% (16/160) in cases in which EMS responded first (relative risk [RR] 0.63, 95% CI = 0.17 to 2.39, p = 0.45). Survival to hospital discharge for VT/VF OHCA did not improve from the prestudy period (16/204, 7.8%) to after police AED availability (19/180, 10.6%) (RR 0.72, 95% CI = 0.36 to 1.45, p = 0.38). CONCLUSIONS: Out-of-hospital cardiac arrest survival in suburban and rural Indiana did not improve after police were equipped with AEDs, likely related to poor police response.

Adult↗
PubMed1997

Iridium oxide-coated defibrillation electrode: reduced shock polarization and improved defibrillation efficacy.

BACKGROUND: Transvenous implantable cardioverter-defibrillator (ICD) leads are designed to deliver electric shocks to the heart for termination of ventricular dysrhythmias. However, the efficiency of different lead materials has not been well studied. This study compares an ICD lead coated with iridium oxide (IROX), a material that reduces shock-induced polarization, with an otherwise identical, uncoated lead. METHODS AND RESULTS: The defibrillation threshold (DFT) was determined in 13 swine with both IROX-coated and uncoated ICD leads paired with an uncoated "can" electrode. The leads were exchanged through a Teflon sheath to reproduce the intracardiac position. The delivered energy DFT of the IROX-coated lead was 15.9+/-5.4 J and was significantly lower than the delivered energy DFT of the uncoated lead (19.1+/-5.1 J; P<.006). The initial lead impedance was equivalent in both leads (IROX, 41.7+/-5.8 omega; uncoated, 41.3+/-4.7 omega; P=NS) at DFT. However, the impedance rose by 7.3+/-2.0 omega during the first phase and by 3.7+/-2 omega during the second phase with the uncoated lead, whereas the corresponding impedance change was 1.0+/-0.3 omega during phase 1 and 1.6+/-0.5 omega during phase 2 (P<.01 each phase) when the IROX-coated lead was used. CONCLUSIONS: This study shows that an IROX coating of this lead system significantly lowers the DFT energy in the swine model. The blunting of the impedance rise by the IROX coating that is seen is consistent with a reduction in electrode polarization.

Animals↗
PubMed1975

[Distribution of the density of defibrillating current in the chest and underneath the defibrillator's electrodes].

Results of experiments carried out in animals and of measurements made on electrophysical and analogue models are presented. It has been found that with routinely employed manipulations in the electric impulse therapy of arrhythmias the denstiy of the current in the chest and directly underneath the defibrillator's electrodes is distributed in a non-uniform fashion. This results in high defibrillation thresholds, possible damages of the heart and body teguments. The causes responsible for this non-uniformity are analyzed, the non-uniformity itself is assessed and ways of its elimination are indicated.

Animals↗
PubMed2006

[Spanish registry of implantable cardioverter defibrillator. Second official report of the Spanish Society of Cardiology Working Group on Implantable Cardioverter Defibrillators (2005)].

INTRODUCTION AND OBJECTIVE: We report the results for the Spanish Registry on Implantable Cardioverter Defibrillators (ICD) (year 2005), developed by the Working Group on ICD of the Spanish Society of Cardiology. METHODS: Data were collected (prospectively in 77% of implants) by single page form questionnaires transmitted after the procedure to the Spanish Society of Cardiology. Participation was voluntary. RESULTS: The number of implants sent to the Registry was 2050 and this represents 74.4% of the total ICDs implanted. The implantation rate per million was 46.5 and the estimated total implantation rate per million was 62.5. The proportion of first implants was 70.3%. The majority of patients were males, with a median age of 65 years, severe or moderate to severe left ventricular dysfunction and in functional class II or I. Ischemic heart disease was the more frequent underlying heart disease followed by dilated cardiomyopathy. The main reason for ICD indication was secondary prevention related to sustained monomorphic ventricular tachycardia or aborted sudden cardiac death. A significant number of prophylactic indications were done, specially in non ischemic heart disease. The proportion of ICD implanted at the electrophysiology laboratory by cardiac electrophysiologist continues increasing. There was an increase in the number of ICD plus cardiac resynchronization therapy, that represent a 23.6% of the implants. The incidence of complications during the implant was very low. CONCLUSIONS: The National Registry on ICD, with a participation rate greater than in previous years, provides a representative sample of the ICD implants performed at our country.

Adolescent↗