Implantable Cardioverter–Defibrillators for Primary Prevention of Sudden Cardiac Death

Sudden cardiac death (SCD) remains a major cause of death in the industrialised world. Implantable cardioverter–defibrillators (ICDs) have been shown to be an effective therapy option for the primary prevention of SCD in patients at high risk of SCD. This review will discuss adequate risk stratification in various disease states, such as coronary artery disease, ischaemic and non-ischaemic cardiomyopathies (dilated cardiomyopathy, hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy), channelopathies (Brugada syndrome, long- QT syndrome, short-QT syndrome, catecholaminergic polymorphic ventricular tachycardia) and congenital heart diseases, to identify patients at high risk of SCD and selection criteria for ICD therapy. The most important clinical primary prevention trials will be highlighted. Finally, complications of device therapy and quality of life issues will be addressed.