DECLINE OF DEFIBRILLATION TESTING USE IN CLINICAL
PRACTICE: AN 8-YEAR NATION-WIDE ASSESSMENT
Eraldo Occhetta - Ospedale Maggiore della Carità, Novara, Italy; Maria Grazia Bongiorni - University
Hospital of Pisa, Pisa, Italy; Alessandro Proclemer - Ospedale Santa Maria della Misericordia, Udine,
Italy; Stefano Favale - Ospedale Consorziale Policlinico, Bari, Italy; Maurizio Gasparini - IRCCS
Istituto Clinico Humanitas, Rozzano, Italy; Francesco Accardi - Boston Scientific, Milan, Italy; Sergio
Valsecchi - Boston Scientific, Milan, Italy; Michele Brignole - Ospedali del Tigullio, Lavagna, Italy
Purpose: Although defibrillation testing (DT) is a standard procedure, there is ongoing debate as to the
need to conduct it at the time of ICD implantation. We assessed the Italian clinical practice of DT
during a 8-year time frame.
Methods and results: According to a survey performed in 2005 among 229(67%) Italian centers, DT
was not performed in 2356(30%) patients who underwent de-novo ICD implantation; DT was
performed in<25% of patients in 15% of centers and in>75% of patients in 59% of centers. We repeated
the survey in 2013 in 276 centers. DT was not performed in 5163(72%) patients; DT was performed
in<25% of patients in 72% of centers and in>75% of patients in 23% of centers.
Conclusions: The practice of DT is significantly changed over 8 years in Italy. Most
electrophysiologists, in Italy more than elsewhere, spontaneously modified their clinical practice, even
in the absence of scientific evidence or clear recommendations. New evidence are warranted to support
the scientific community in producing recommendations and the manufacturers in obtaining regulatory
approval for revision of the information for use of ICDs.