Risk of defibrillation threshold testing in severe heart failure patient: A case of cardiac resynchronization therapy (CRT-D) with acute myocardial infarction

AbstractDefibrillation threshold (DFT) testing is usually recommended after device implantation to confirm appropriate implantable cardioverter defibrillator (ICD)/cardiac resynchronization therapy defibrillator (CRT-D) function [1,2]. However, induction of ventricular fibrillation may result in hemodynamic compromise, and cardioversion itself may cause myocardial injury [3,4]. We report on a CRT-D patient with acute myocardial infarction who died due to multiple organ failure 1 day after DFT testing. Our case emphasizes the importance of deciding whether DFT testing should be performed for patients with very severe heart failure in the acute stage of myocardial infarction