Reassessing Risk Factors for High Defibrillation Threshold: The EF-SAGA Risk Score and Implications for Device Testing.

Objectives: To reevaluate risk factors for high defibrillation threshold (DFT) and propose a risk assessment tool.

Background: Controversy exists over routine DFT testing during implantable cardioverter defibrillator (ICD) placement.

Methods: We retrospectively analyzed 1,642 consecutive patients who received an ICD and underwent DFT testing.

Intercostal muscle twitching from right ventricular apical pacing.

A patient with a dilated cardiomyopathy underwent successful implantation of a cardiac resynchronization therapy defibrillator. The device system included an active fixation lead placed at the right ventricular (RV) apex. Pacing from the RV apex unexpectedly led to left-sided intercostal muscle stimulation and twitching.

Reversible cardiomyopathy in an adolescent with idiopathic aortic cusp ventricular tachycardia.

This report describes the case of an asymptomatic patient with a ventricular tachycardia-induced cardiomyopathy that resolved completely after successful radiofrequency ablation. This type of presentation and outcome has not been reported in the pediatric literature.