Relation of echocardiographic wall motion score index and response to dobutamine stress to defibrillation threshold at the time of implantation of a cardiac defibrillator

Am J Cardiol. 2005 May 1;95(9):1099-101. doi: 10.1016/j.amjcard.2005.01.026.

Abstract

Predictors of defibrillation threshold (DFT) at implantation remain poorly defined. It was hypothesized that a greater wall motion score index (WMSI) at rest on echocardiography and an ischemic or biphasic response on dobutamine stress echocardiography (DSE) would predict a greater DFT. Consecutive patients who underwent implantable cardiac-defibrillator implantation underwent echocardiography and DSE. DFT at implantation was assessed using the step-down method. Thirteen men aged 68 +/- 10 years with left ventricular ejection fractions of 28 +/- 10% participated in the study. DFTs ranged from 5 to 25 J (mean 14 +/- 8). A WMSI at rest of > or = 2.5 had a 71% positive predictive value and an 83% negative predictive value for a DFT > or = 15 J. An ischemic or biphasic response during DSE did not predict a greater DFT at implantation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arrhythmias, Cardiac / diagnostic imaging*
  • Arrhythmias, Cardiac / surgery*
  • Defibrillators, Implantable*
  • Dobutamine
  • Echocardiography, Stress*
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / physiopathology*
  • Humans
  • Male
  • Prognosis
  • Prospective Studies
  • Prosthesis Implantation
  • Stroke Volume / physiology*
  • Time Factors
  • Treatment Outcome

Substances

  • Dobutamine