Quick ICD Study: Is Extensive Electrophysiological Testing Before, During and After ICD-Implantation Still Necessary ?
Quick ICD Study: Is Extensive Electrophysiological Testing Before, During and After ICD-Implantation Still Necessary ?
The purpose of this study is to evaluate the strategy of implanting an ICD with or without
 EPS before, during and after ICD-implantation in a randomised controlled trial, using a
 combined endpoint of major ICD-related adverse events as the primary outcome measure.
Usually, EPS before and during ICD-implantation is performed to allow risk stratification, to
 test serial antiarrhythmic drugs, to find suitable ablation sites in patients with
 hemo-dynamically stable monomorphic VTs, to exclude supraventricular tachycardias as a cause
 of cardiac arrest and to help programming detection rate and enhancement criteria in the ICD.
 However, routine EPS preceeding ICD-implantation exposes the patient to some risk and the
 health care system to considerable costs. So the question has been raised, whether such
 testing is still necessary and costseffective, if the indiaction for ICD-implantation is
 clear on a clinical ground.The purpose of this study is to evaluate the strategy of
 implanting an ICD with or without EPS before during and after ICD-implantation in a
 randomised controlled trial, using a combined endpoint of major ICD-related adverse events as
 the primary outcome measure (see details under "Endpoints"). The results will be viewed
 against the extra costs and patients´ quality of life both study arms.Secondary outcomes are
 considered as differences in decisions between the groups and difference of events in the two
 groups.
Inclusion Criteria:

 -  structural heart disease and survived cardiac arrest or hemodynamically unstable VT
 (bpm > 200/min)

 Exclusion Criteria:

 -  conditions, which make a secondary cause for cardiac arrest probable or are not
 compatible with a single chamber ICD; co-morbidity, prior ICD PM, or EPS