scholarly journals Implantable cardioverter defibrillator for the prevention of sudden cardiac death: Systematic review and pooled analysis

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Aref Albakri
2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Franke ◽  
H Marshall ◽  
P Kennewell ◽  
H D Pham ◽  
T Rattanakosit ◽  
...  

Abstract Background Implantation of implantable cardioverter defibrillator (ICD) is a Class IIb indication in patients with Cardiac Sarcoid and with LVEF 36%-49% despite immunosuppression and optimal heart failure therapy. Purpose This systematic review and meta-analysis aimed to provide an estimate on the incidence of ventricular arrhythmias and risk of sudden cardiac death (SCD) in patients with CS. Methods The terms “Cardiac Sarcoidosis*” AND “Implantable Cardioverter Defibrillator” AND “Sudden Cardiac Death” were searched on PubMed, EMBASE, and Scopus on 21st of September 2018 yielding 759 articles. After exclusions, 12 studies met inclusion criteria. Results The 12 studies consisted of 612 patients with CS of which 534 had ICD implanted for primary or secondary prevention. Assuming appropriate device therapy as a surrogate for SCD, the annual incidence of appropriate ICD therapies and SCD combined was 6.3% (95% CI; 3.5%-9.1%) in primary prevention cohorts, 11.6% (95% CI; 7.8%-15.3%) in secondary prevention cohorts, and 8.7% (95% CI; 6.0%-11.5%) in both cohorts. The mean left ventricular ejection fraction (LVEF) was pooled as 59±7 (n=155) in primary prevention cohorts and 48±15 (n=48) in secondary prevention cohorts. However, the LVEF was 35±13 (n=28) in those with appropriate ICD therapy, and 49±16 (n=47) in those with ICDs without therapy. Incidence of SCD in Combined Cohorts Conclusion The incidence of ventricular arrhythmias and SCD is high not only secondary but also in primary prevention cohorts of CS. This data supports the role of implanting ICDs for primary prevention in patients with CS with mild to moderate reduction in LVEF. Acknowledgement/Funding None


2012 ◽  
Vol 5 (3) ◽  
pp. e166-e170 ◽  
Author(s):  
Fabio Marsico ◽  
Gianluigi Savarese ◽  
Celestino Sardu ◽  
Cristoforo D’Ascia ◽  
Donatella Ruggiero ◽  
...  

Author(s):  

Dilated cardiomyopathy (DCM) is a disease characterised as left ventricular (LV) or biventricular dilatation with impaired systolic function. Regardless of underlying cause patients with DCM have a propensity to ventricular arrhythmias and sudden cardiac death. Implantable Cardioverter Defibrillator (ICD) implantation for these patients results in significant reduction of sudden cardiac death [1-3]. ICD devices may be limited by right ventricle (RV) sensing dysfunction with low RV sensing amplitude. We present a clinical case of patient with DCM, implanted ICD and low R wave sensing on RV lead.


This chapter looks at the diagnosis and management of tachycardias, including both narrow complex tachycardias and broad complex tachycardias. Atrial fibrillation (AF) is the most common sustained arrhythmia, affecting 1–2% of the general population (5–15% of those over 80 years). There have been a number of developments in arrhythmia care over the last few years in particular in relation to AF and there are now more specialist arrhythmia nurses and nurse-led arrhythmia services than before. AF, arrhythmias, and sudden cardiac death are priority areas of NHS improvement. Recent guidelines for the management of tachycardias are discussed including pharmacological measure, cardioversion, and implantable cardioverter-defibrillator (ICD) insertion.


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