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How to manage the patient with a high defibrillation threshold

      Defibrillation threshold (DFT) testing is an integral part of implantable cardioverter-defibrillator (ICD) placement and follow-up. Unfortunately, the DFT can vary widely from day to day, influenced by many factors including electrolytes, sympathetic tone, antiarrhythmic drugs, and other medications. For this reason, a 10-J safety margin between the lowest successful defibrillation energy during testing and the maximal device output has been widely adapted as standard practice.
      • Marchlinski F.E.
      • Flores B.
      • Miller J.M.
      • Gottlieb C.D.
      • Hargrove 3rd, W.C.
      Relation of the intraoperative defibrillation threshold to successful postoperative defibrillation with an automatic implantable cardioverter defibrillator.
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