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

Ilan Goldenberg, David T. Huang, Jens Cosedis Nielsen

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish
Pages (from-to)2003-2011
Number of pages9
JournalEuropean Heart Journal
Volume41
Issue number21
DOIs
StatePublished - 1 Jun 2020
Externally publishedYes

Keywords

  • ICD
  • Primary prevention
  • Sudden cardiac death
  • Ventricular tachyarrhymias

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