Another important question about this issue is whether or not defibrillation threshold testing is at all necessary or recommended for people who have a defibrillator implant for primary prevention. For the most part we do not test for defibrillation threshold or a safety margin. An exception is for patients who require a right sided implant. If the original indication was recurrent VT or Sudden cardiac death, we would do the testing. Propofol is used briefly at the time of induction. Most of the procedure is done with local anesthesia.