Defibrillation testing in everyday medical practice during implantable cardioverter defibrillator implantation in France: Analysis from the LEADER registry

Summary Background Defibrillation testing (DT) is usually performed during implantable cardioverter defibrillator (ICD) implantation. Aims We conducted a multicentre prospective study to determine the DT procedures used in everyday practice, to compare the characteristics of patients with or without DT, and to compare severe adverse events in these two populations during implantation and follow-up. Methods The LEADER registry enrolled 904 patients included for primo-implantation of a single ( n  = 261), dual ( n  = 230) or triple ( n  = 429) defibrillation system in 42 French centres. Results Baseline characteristics of patients (62.0 ± 13.5 years; 88% men; primary indication 62%) who underwent ventricular fibrillation (VF) induction (VF induction group, n  = 810) and those who did not (untested group, n  = 94, representing 10.4% of the entire study population) revealed that the untested group were older ( P P P P  = 1.000). Conclusions In this study, more than 10% of ICD patients were implanted without VF induction. Untested patients appeared to be sicker than tested patients, with a more severe long-term outcome, but without any difference in mortality due to arrhythmic events.