Preface

**Section 4 ICD Implantation Procedure 107**

Joern Schmitt

**VI** Contents

Munir Zaqqa

Martin Seifert

**Discrimination 161**

**Periprocedural Issues 109**

Chapter 8 **Defibrillator Threshold Testing 121**

**Section 5 Tipps and Tricks in ICD Programming 135**

Chapter 9 **Tachycardia Discrimination Algorithms in ICDs 137**

Chapter 10 **Current Issues in ICD SVT-VT Discrimination: Pacing for SVT-VT**

Kevin A Michael, Damian P Redfearn and Mark L Brown

Chapter 7 **ICD and PM Implantation Procedure: Relevant**

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-todate".

#### **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**

**External Cardiac Defibrillation**

**Chapter 1**

**Principles of External Defibrillators**

Hugo Delgado, Jorge Toquero, Cristina Mitroi, Victor Castro and Ignacio Fernández Lozano

Additional information is available at the end of the chapter

Electrical defibrillation is the only effective therapy for cardiac arrest caused by ventricular fibrillation (VF) [1, 2] or pulseless ventricular tachycardia (VT). Scientific evidence to sup‐ port early defibrillation is overwhelming [3-5], being delay from collapse to delivery of the first shock the single most important determinant of survival [6, 7]. If defibrillation is deliv‐ ered promptly, survival rates as high as 75% have been reported [8, 9]. The chance of a fa‐ vourable outcome decline at a rate of about 10% for each minute cardiac defibrillation is

The guidelines on cardiopulmonary resuscitation of the European Resuscitation Council and American Heart Association (AHA) strongly recommend attempting defibrillation with minimal delay in victims of VF/VT cardiac arrest. As this event occurs most often in the vic‐ tim's private home or in public spaces away from healthcare facilities, the need for early de‐ fibrillation has led to the development of automatic, portable defibrillators (Automated

The purpose of this chapter is to review the mechanisms of external defibrillation, the availa‐ ble types of AEDs including the wearable cardioverter-defibrillator, its uses and limitations.

In Switzerland, 1899, Prevost and Batelli discovered that small electric shocks could induce ventricular fibrillation in dogs and that larger charges would reverse the condition. Howev‐

and reproduction in any medium, provided the original work is properly cited.

© 2013 Delgado et al.; licensee InTech. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© 2013 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution,

**2. Cardiac external defibrillation – Basic science**

http://dx.doi.org/10.5772/52512

**1. Introduction**

delayed [3, 10].

**2.1. History**

External Defibrillator - AED).
