Background: Defibrillation testing can be done either via an external cardiac defibrillator or directly via the implanted defibrillator during implantation (device-based testing). The advantage of one testing methodology over the other has not been adequately studied.

Methods And Results: Seventy-four patients (72% men) were randomized into two groups depending on the defibrillation testing methodology used--external cardiac defibrillation and device-based testing groups. R-wave, pacing threshold, pacing impedance, defibrillation threshold, defibrillation pathway impedance and total procedure time were not significantly different between the two groups.

Conclusions: Device-based testing did not significantly reduce the procedure time. Lead and defibrillation parameters were similar in both the groups; lead repositioning and replacement were required in three patients in the external cardiac defibrillation group.

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