Introduction: Improved technology, the use for primary prevention of sudden cardiac death and potential risks of defibrillation testing (DT) have caused doubts on the necessity of intraoperative testing with Implantable Cardiac Defibrillators (ICD).
Methods: PANORAMA is a long term, multi-center, prospective, non-randomized observational study. We analyzed the current practice of ICD testing at 100 hospitals across 6 geographical regions. In total 2084 subjects were implanted with an ICD (N=1405) or CRT-D (N=679) between 2005 and 2011.
Results: Overall 51% devices were implanted without testing. DT ranged from 28% (Middle East) to 71 % (South Africa) and decreased over time. In 29 centers all implanted devices were tested, 38 centers tested <50% including 11 centers not testing.
Multivariate logistic regression analysis identified the parameters (table 2) as independent predictors for testing.
Conclusions: There are significant differences between and within global regions in current practice of ICD and CRT-D testing with a large proportion of not tested devices and a general trend to less testing. PANORAMA will follow up the impact of the observed differences on patient’s outcome in the long term.