The role of implantable cardioverter-defibrillators and sudden cardiac death prevention: indications, device selection, and outcome

2019 ◽  
Vol 41 (21) ◽  
pp. 2003-2011 ◽  
Author(s):  
Ilan Goldenberg ◽  
David T Huang ◽  
Jens Cosedis Nielsen
Keyword(s):  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Current Knowledge ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Implantable Cardioverter Defibrillators ◽  
Icd Implantation ◽  
Device Selection ◽  
Cardioverter Defibrillators

Abstract Multiple randomized multicentre clinical trials have established the role of the implantable cardioverter-defibrillator (ICD) as the mainstay in the treatment of ventricular tachyarrhythmias and sudden cardiac death (SCD) prevention. These trials have focused mainly on heart failure patients with advanced left ventricular dysfunction and were mostly conducted two decades ago, whereas a more recent trial has provided conflicting results. Therefore, much remains to be determined on how best to balance the identification of patients at high risk of SCD together with who would benefit most from ICD implantation in a contemporary setting. Implantable cardioverter-defibrillators have also evolved from the simple, defibrillation-only devices implanted surgically to more advanced technologies of multi-chamber devices, with physiologic bradycardic pacing, including cardiac resynchronization therapy, atrial and ventricular therapeutic pacing algorithms, and subcutaneous ICDs. These multiple options necessitate individualized approach to device selection and programming. This review will focus on the current knowledge on selection of patients for ICD treatment, device selection and programming, and future directions of implantable device therapy for SCD prevention.

scholarly journals Implantable cardioverter defibrillators in the prevention of sudden cardiac death

2017 ◽  
Vol 89 (12) ◽  
pp. 103-109
Author(s):  
L A Bockeria ◽  
N M Neminushchiy ◽  
S I Mikhaylichenko ◽  
S A Novichkov ◽  
E E Achkasov
Keyword(s):  
Sudden Cardiac Death ◽  
Secondary Prevention ◽  
Cardiac Death ◽  
Antiarrhythmic Drugs ◽  
Implantable Cardioverter Defibrillators ◽  
Primary And Secondary Prevention ◽  
Multicenter Studies ◽  
Cardioverter Defibrillators

The article highlights the role of implantable cardioverter defibrillators (ICDs) in the primary and secondary prevention of sudden cardiac death. It considers the results of multicenter studies comparing the efficacy of antiarrhythmic drugs and implantable devices in the primary and secondary prevention of sudden cardiac death, including that in patients with nonischemic cardiomyopathy and discusses quality of life in patients with ICDs.

scholarly journals Implantable Cardioverter-Defibrillators are the Main Link in the Modern Concept of Sudden Cardiac Death Prevention. Problems and Prospects of the Development of the Method

Kardiologiia ◽  
2018 ◽  
Vol 58 (12) ◽  
pp. 76-84
Author(s):  
L. A. Bokeria ◽  
N. M. Neminushchiy ◽  
A. S. Postol
Keyword(s):  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Predictive Accuracy ◽  
Left Ventricular ◽  
Modern Concept ◽  
Implantable Cardioverter Defibrillators ◽  
Practical Application ◽  
Implantable Defibrillators ◽  
The Moment ◽  
Cardioverter Defibrillators

The article covers the development of the problem of sudden cardiac death prevention with the implantable cardioverter­defibrillators from the moment of creation of these devices to our days. The current concept of primary prevention of sudden cardiac death, based on the severity of manifestation of heart failure and left ventricular dysfunction, is not effective enough. Its practical application is difficult because it requires mass application of implantable defibrillators, with low predictive accuracy of these criteria in terms of development of life­threatening arrhythmias. The development of methods for visualizing the myocardium, allowing to assess the severity of myocardial fibrosis, as well as the possibilities of medical genetics, at the present stage, allows us to clarify indications for implantation of cardioverter­defibrillators and thereby significantly improve the concept of preventing sudden cardiac death with these instruments.

scholarly journals CIED guideline recommendations in the setting of advisories

2021 ◽  
Author(s):  
Michael Sawyer ◽  
Paul Gould
Keyword(s):  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Electronic Device ◽  
Implantable Cardioverter Defibrillators ◽  
Cardiac Implantable Electronic Device ◽  
Icd Implantation ◽  
Cardioverter Defibrillators

Subcutaneous implantable cardioverter defibrillators (S-ICDs) are currently indicated for patients who meet ICD implantation criteria for the prevention of sudden cardiac death (SCD). In December 2020, a unique cardiac implantable electronic device (CIED) situation arose as both the S-ICD generator and electrode were under a device advisory. We would recommend all future CIED implantation guidelines receive a caveat regarding checking current CIED advisories, in order to avoid future similar scenarios.

scholarly journals Wearable cardioverter-defibrillators after myocardial infarction: a review of its clinical utility and unmet needs in current clinical practice

2021 ◽  
Author(s):  
Hirofumi Hioki ◽  
Ken Kozuma ◽  
Yoshio Kobayashi ◽  
Kenji Ando ◽  
Yoshihiro Morino ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Implantable Cardioverter Defibrillators ◽  
Ventricular Ejection Fraction ◽  
Cardioverter Defibrillator ◽  
Cardioverter Defibrillators

AbstractSudden cardiac death is one of the leading causes of death in the older population. Compared with the general population, patients who experienced a myocardial infarction are four to six times more likely to experience sudden cardiac death. Though primary percutaneous coronary intervention considerably reduces mortality in patients who experienced a myocardial infarction, a non-negligible number of sudden cardiac deaths still occurs. Despite the high incidence rate of sudden cardiac deaths during the first month after myocardial infarction, prophylactic use of implantable cardioverter-defibrillators has so far failed to convey a survival benefit. Therefore, current clinical guidelines recommend that cardioverter-defibrillator implantation is contraindicated until 90 days after myocardial infarction. Wearable cardioverter-defibrillators were first approved for clinical use in 2002 and are currently considered as a bridge to therapy in patients with myocardial infarction with a reduced left ventricular ejection fraction in whom cardioverter-defibrillator implantation is temporarily not indicated. However, there is insufficient recognition among interventional cardiologists of the use of wearable cardioverter-defibrillators for preventing sudden cardiac death after myocardial infarction. Hence, we reviewed the evidence of the efficacy of wearable cardioverter-defibrillators used in patients following myocardial infarction to achieve better management of sudden cardiac death.

Abstract 12621: Gender Differences Among Implantable Cardioverter Defibrillators Recipients in the Setting of Primary Prevention

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Eloi Marijon ◽  
Rui Providencia ◽  
Pascal Defaye ◽  
Didier Klug ◽  
Daniel Gras ◽  
...  
Keyword(s):  
Primary Prevention ◽  
Dilated Cardiomyopathy ◽  
Specific Interaction ◽  
Severe Heart Failure ◽  
Real Life ◽  
Functional Class ◽  
Cardiac Resynchronization ◽  
Implantable Cardioverter Defibrillators ◽  
Icd Implantation ◽  
Cardioverter Defibrillators

Background: Data regarding sex specificities in the use, benefits and complications of implantable cardioverter-defibrillators (ICDs) in primary prevention in the real-world European setting are sparse. Methods: Using a large multicentric cohort of consecutive patients referred for ICD implantation for primary prevention (2002-2012), in the setting of coronary artery disease or dilated cardiomyopathy, we examined potential sex differences in subjects’ characteristics and outcomes. Results: Of 5,539 patients, only 837 (15.1%) were women and 53.8% received cardiac resynchronization therapy (CRT-D). Compared to men, women presented a significantly higher proportion of dilated cardiomyopathy (60.2% vs. 36.2%, P120ms: 74.6% vs. 68.5%, P=0.003), higher New York Heart Association functional class (2.5±0.7 vs. 2.4±0.7, P=0.003) and lower prevalence of atrial fibrillation (18.7% vs. 24.9%, P<0.001). During a 16,786 patient-years follow-up, overall, fewer appropriate therapies were observed in women (HR = 0.59, CI95% 0.45-0.76; P<0.001). By contrast, no sex-specific interaction was observed for inappropriate shocks (OR for women = 1.00, 95%CI 0.74-1.35, P=0.997) and mortality (HR = 0.87; 95%CI 0.66-1.15, P=0.324), with similar patterns of cause of deaths. Conclusion: In our real life registry, women account for the minority of ICD recipients. While female ICD recipients present with features of more severe heart failure in the setting of primary prevention of sudden cardiac death, we observed they have a 40% lower incidence of appropriate therapies.

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