Implication of PEFA

The importance of PEFA is that it gives a rational basis for the management of patients who that diseases that place them at

some risk of sudden death, while the majority of patients are not at risk

The treatment of these patients is to implant an Implantable CardioverterDefibrillator (ICD).  This is a device permenently implanted in the chest wall with a lead running into the heart.  The device will sense a potentially dangerous arrhythmia and apply a corrective "shock" to convert the heart back into a normal rhythm.


These devices have major disadvantages:

  • They have a psychological burden
  • They have major complications (including death)
  • They are extremely expensive and ICDs account for a significant fraction of health care budgets.
  • Only a minority (~20%) ever deliver therapy.


The identification of patients who are at risk of SCD is at present highly unsatisfactory and leads to either high risk patients not being identified or a very large number of patients receiving ICDs when they do not need one.


PEFA has the potential to resolve some of these issues leading to better clinical practice and reduction of health care costs.



iA video describing PEFA can be seen in the nest screen (Video)


  • Paced
  • Electrogram
  • Fractionation
  • Analysis
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