SIMPLE (Shockless Implant Evaluation) trial<\/a>, sponsored by\u00a0Boston Scientific\u00a0and led by researchers at McMaster University in Hamilton, Ontario, 2,500 patients in 18 countries undergoing ICD implantation were randomized to routine defibrillation testing (DT) or no DT.<\/p>\nAfter three years of followup there was no significant difference in the primary endpoint of the trial, which was the rate of death due to arrhythmia or the failure of a first shock to terminate a lethal arrhythmia (7.2% in the no-DT arm versus 8.3% \u00a0in the DT arm, hazard ratio 0.86; CI 0.65-1.14, \u00a0non-inferiority p<0.001). There was no difference between the groups in total mortality.<\/p>\n
The authors concluded that defibrillation testing “does not improve ICD shock efficacy or reduce mortality.” Although routine testing is “generally low risk,” complications may occasionally take place. Because of these facts, “the ‘no testing’ approach to routine ICD implantation should be preferred.”<\/p>\n
\u201cThis is the first time the relationship between defibrillator testing and patient outcome has been studied independently in a randomized setting and with these results, we can confidently say that defibrillator testing, although safe, is not necessary at the time of ICD implantation,\u201d said the lead author of the study, Jeff Healey, in a press release. \u201cThese results should change physician practice and could help reduce costs without compromising patient outcomes.\u201d<\/p>\n
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<\/p>\n","protected":false},"excerpt":{"rendered":"
Although commonly performed, routine defibrillation testing has never been shown to be safe or necessary.\u00a0Now a new study, presented yesterday at the Heart Rhythm Society meeting in San Francisco, offers evidence that although routine testing is generally safe it may increase complications without producing any improvement in outcomes. In the\u00a0SIMPLE (Shockless Implant Evaluation) trial, sponsored […]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[13],"tags":[2248,2249,448],"class_list":["post-43194","post","type-post","status-publish","format-standard","hentry","category-electrophysiology","tag-defibrillation-testing","tag-icd-implantation","tag-icds"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/43194","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=43194"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/43194\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=43194"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=43194"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=43194"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}