CARDIAC DEFIBRILLATION Edited by Damir Erkapic, Tamas Bauernfeind CARDIAC DEFIBRILLATION Edited by Damir Erkapic, Tamas Bauernfeind Cardiac Defibrillation http://dx.doi.org/10.5772/45990 Edited by Damir Erkapic, Tamas Bauernfeind Contributors Kevin Michael, Damir Erkapic, Tamas Bauernfeind, Jorge Toquero, Dan Blendea, Craig McPherson, Razvan Dadu, Marzia Giaccardi, Elisabete Martins, Joern Schmitt, Martin Seifert, Jerome Taieb, Munir Zaqqa Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2013 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Iva Simcic Technical Editor InTech DTP team Cover InTech Design team First published January, 2013 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from [email protected] Cardiac Defibrillation, Edited by Damir Erkapic, Tamas Bauernfeind p. cm. ISBN 978-953-51-0931-0 Contents Preface VII Section 1 External Cardiac Defibrillation 1 Chapter 1 Principles of External Defibrillators 3 Hugo Delgado, Jorge Toquero, Cristina Mitroi, Victor Castro and Ignacio Fernández Lozano Section 2 Principals of Internal Cardiac Defibrillation 27 Chapter 2 Defibrillation and Cardiac Geometry 29 Dan Blendea, Razvan Dadu and Craig A. McPherson Section 3 Worth Knowing About Indication, Long-Term Benefit, Challenges, and Monitoring of ICD Therapy 43 Chapter 3 Sudden Death in Ischemic Heart Disease 45 Elisabete Martins Chapter 4 Implantable Cardioverter-Defibrillators in Sudden Cardiac Death Prevention: What Guidelines Don't Tell 59 Marzia Giaccardi, Andrea Colella, Giovanni Maria Santoro, Alfredo Zuppiroli and Gian Franco Gensini Chapter 5 Long-Term Benefit and Challenges of Implantable Cardioverter Defibrillator Therapy 79 Damir Erkapic and Tamas Bauernfeind Chapter 6 ICD in the Era of Telecardiology 93 J. Taieb, J. Bouet, R. Morice, J. Hourdain, B. Jouve, Y. Rahal, T. Benchaa, H. Khachab, O. Rica and C. Barnay VI Contents Section 4 ICD Implantation Procedure 107 Chapter 7 ICD and PM Implantation Procedure: Relevant Periprocedural Issues 109 Joern Schmitt Chapter 8 Defibrillator Threshold Testing 121 Munir Zaqqa Section 5 Tipps and Tricks in ICD Programming 135 Chapter 9 Tachycardia Discrimination Algorithms in ICDs 137 Martin Seifert Chapter 10 Current Issues in ICD SVT-VT Discrimination: Pacing for SVT-VT Discrimination 161 Kevin A Michael, Damian P Redfearn and Mark L Brown Preface In highly developed countries, sudden cardiac death (SCD) caused by ventricular fibrillation or tachycardia (VF/VT) plays a prominent role in mortality since several decades. The invention of cardiac defibrillation proved to be a decisive step in the therapy and prophylaxis of SCD. As internal cardioverter defibrillator (ICD) therapy became widely available, a continuous development followed in the number and type of leads, programming capabilities and differential algorithms of these devices. Indications for ICD therapy also underwent consecutive changes and actualizations. However, several important issues concerning contraindications, possible complications, perioperative management including anticoagulation and antibiotic therapy, and the programming and follow-up of ICD devices are much less discussed in the available guidelines. In this book we tried to round up practical advices and protocols from colleagues working in the USA, Canada, Jordan, Portugal, Spain, France, Italy and Germany. We hope that you will find this book helpful for cardiologists and electrophysiologists to keep their knowledge “up-to- date”. Editor: Dr. Damir Erkapic, M.D. University of Giessen and Marburg, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany Co-editor: Dr. Tamas Bauernfeind, M.D. SRH Zentralklinikum Suhl gGmbH Internal Medicine I Suhl, Germany Section 1 External Cardiac Defibrillation