Implantable cardioverter defibrillator

Jump to navigation Jump to search

WikiDoc Resources for Implantable cardioverter defibrillator

Articles

Most recent articles on Implantable cardioverter defibrillator

Most cited articles on Implantable cardioverter defibrillator

Review articles on Implantable cardioverter defibrillator

Articles on Implantable cardioverter defibrillator in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Implantable cardioverter defibrillator

Images of Implantable cardioverter defibrillator

Photos of Implantable cardioverter defibrillator

Podcasts & MP3s on Implantable cardioverter defibrillator

Videos on Implantable cardioverter defibrillator

Evidence Based Medicine

Cochrane Collaboration on Implantable cardioverter defibrillator

Bandolier on Implantable cardioverter defibrillator

TRIP on Implantable cardioverter defibrillator

Clinical Trials

Ongoing Trials on Implantable cardioverter defibrillator at Clinical Trials.gov

Trial results on Implantable cardioverter defibrillator

Clinical Trials on Implantable cardioverter defibrillator at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Implantable cardioverter defibrillator

NICE Guidance on Implantable cardioverter defibrillator

NHS PRODIGY Guidance

FDA on Implantable cardioverter defibrillator

CDC on Implantable cardioverter defibrillator

Books

Books on Implantable cardioverter defibrillator

News

Implantable cardioverter defibrillator in the news

Be alerted to news on Implantable cardioverter defibrillator

News trends on Implantable cardioverter defibrillator

Commentary

Blogs on Implantable cardioverter defibrillator

Definitions

Definitions of Implantable cardioverter defibrillator

Patient Resources / Community

Patient resources on Implantable cardioverter defibrillator

Discussion groups on Implantable cardioverter defibrillator

Patient Handouts on Implantable cardioverter defibrillator

Directions to Hospitals Treating Implantable cardioverter defibrillator

Risk calculators and risk factors for Implantable cardioverter defibrillator

Healthcare Provider Resources

Symptoms of Implantable cardioverter defibrillator

Causes & Risk Factors for Implantable cardioverter defibrillator

Diagnostic studies for Implantable cardioverter defibrillator

Treatment of Implantable cardioverter defibrillator

Continuing Medical Education (CME)

CME Programs on Implantable cardioverter defibrillator

International

Implantable cardioverter defibrillator en Espanol

Implantable cardioverter defibrillator en Francais

Business

Implantable cardioverter defibrillator in the Marketplace

Patents on Implantable cardioverter defibrillator

Experimental / Informatics

List of terms related to Implantable cardioverter defibrillator

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]

Overview

An implantable cardioverter-defibrillator (ICD) is a small battery-powered electrical impulse generator which is implanted in patients who are at risk of sudden cardiac death due to ventricular fibrillation and ventricular tachycardia. The device is programmed to detect cardiac arrhythmia and correct it by delivering a jolt of electricity. In current variants, the ability to revert ventricular fibrillation has been extended to include both atrial and ventricular arrhythmias as well as the ability to perform biventricular pacing in patients with congestive heart failure or bradycardia.

Implantation

The process of implantation of an ICD is similar to implantation of a pacemaker. Similar to pacemakers, these devices typically include electrode wire(s) which pass through a vein to the right chambers of the heart, usually being lodged in the apex of the right ventricle. The difference is that pacemakers are more often temporary and generally designed to consistently correct bradycardia, while ICDs are often permanent safeguards against sudden abnormalities.

The most recent development is the subcutaneous ICD (S-ICD). Current state-of-the-art electronics and batteries have enabled an implantable device to deliver enough energy to defibrillate the heart without the need for a lead in or on the heart. This prevents lead-related problems and the risk of dangerous infections in or near the heart. This ICD is positioned just under the skin and outside the ribcage. It can be placed during a minor procedure under conscious sedation. A study of 300 patients is in progress for US approvals.[1]

Working mechanism

ICDs constantly monitor the rate and rhythm of the heart and can deliver therapies, by way of an electrical shock, when the electrical manifestations of the heart activity exceeds the preset number. More modern devices can distinguish between ventricular fibrillation and ventricular tachycardia (VT), and may try to pace the heart faster than its intrinsic rate in the case of VT, to try to break the tachycardia before it progresses to ventricular fibrillation. This is known as fast-pacing, overdrive pacing, or anti-tachycardia pacing (ATP). ATP is only effective if the underlying rhythm is ventricular tachycardia, and is never effective if the rhythm is ventricular fibrillation.

Many modern ICDs use a combination of various methods to determine if a fast rhythm is normal, ventricular tachycardia, or ventricular fibrillation.

Rate discrimination evaluates the rate of the lower chambers of the heart (the ventricles) and compares it to the rate in the upper chambers of the heart (the atria). If the rate in the atria is faster than or equal to the rate in the ventricles, then the rhythm is most likely not ventricular in origin, and is usually more benign. If this is the case, the ICD does not provide any therapy.

Rhythm discrimination will see how regular a ventricular tachycardia is. Generally, ventricular tachycardia is regular. If the rhythm is irregular, it is usually due to conduction of an irregular rhythm that originates in the atria, such as atrial fibrillation.

Morphology discrimination checks the morphology of every ventricular beat and compares it to what the ICD believes is a normally conducted ventricular impulse for the patient. This normal ventricular impulse is often an average of a multiple of beats of the patient taken in the recent past.

Lead II electrocardiogram showing Torsades being shocked by an implantable cardioverter-defibrillator back to the patient's baseline cardiac rhythm.

History

The development of the ICD was pioneered at Sinai Hospital in Baltimore by a team including Michel Mirowski, Morton Mower, and William Staewen.[2] Mirowski teamed up with Mower and Staewen and together they commenced their research in 1969 but it was 11 years before they treated their first patient. Similar developmental work was carried out almost coincidentally by Schuder and colleagues at the University of Missouri.

More than a decade of research went into the development of an implantable defibrillator that would automatically sense the onset of ventricular fibrillation and deliver an electric countershock within 15–20 seconds, converting the rhythm to sinus rhythm. Improved versions were programmed to be able to detect ventricular tachycardia, often a forerunner of ventricular fibrillation. These were then called implantable cardioverters.

The work was commenced against much skepticism even by leading experts in the field of arrhythmias and sudden death. There was doubt that their ideas would ever become a clinical reality. In 1972 Bernard Lown, the inventor of the external defibrillator, stated in the journal Circulation - "The very rare patient who has frequent bouts of ventricular fibrillation is best treated in a coronary care unit and is better served by an effective antiarrhythmic program or surgical correction of inadequate coronary blood flow or ventricular malfunction. In fact, the implanted defibrillator system represents an imperfect solution in search of a plausible and practical application".

The problems to be overcome were the design of a system which would allow detection of ventricular fibrillation or ventricular tachycardia. Despite the lack of financial backing and grants, they persisted and the first device was implanted in February 1980 at Johns Hopkins Hospital by Dr. Levi Watkins, Jr. Modern ICDs do not require a thoracotomy and possess pacing, cardioversion, and defibrillation capabilities.

Internal cardioverter defibrillators have also been used twice in dogs to prevent sudden death from arrhythmia. The first defibrillator was implanted at Washington State University by a team of cardiologists led by Dr Lynne Johnson in 2003. The patient was a Boxer dog with life threatening arrhythmias from arrhythmogenic right ventricular cardiomyopathy, an inherited disease. On July 21, 2008, a second ICD was implanted in a 6-month-old German Shepherd dog with inherited ventricular arrhythmias. The 5-hour long surgery took place at Louisiana State University and was led by Dr Romain Pariaut. So far, these pets are the only two client-owned dogs that have received such a high-tech treatment.

Cardiovascular Implantable Electronic Device Infections

Antimicrobial Regimen

  • 1.1. Early post-implantation inflammation[3][4][5]
  • 1.2. Penicillin allergy or MRSA Colonisation
  • 1.3. Early post-implantation inflammation in penicillin-allergic or MRSA-colonized patient
  • 1.4. Uncomplicated generator pocket infection
  • 1.5. ICED-LI or ICED-IE or complicated generator pocket infection pending blood cultures, e.g. in severe sepsis
  • 1.6. ICED-LI or ICED-IE or generator pocket infection with negative blood cultures

Causes

Common Causes

Causes in Alphabetical Order

Living with an ICD

People that have an implanted cardioverter-defibrillator can live full and happy lives. Usually the ICD improves the living conditions of a patient significantly. As with a pacemaker, living with an ICD does impose some restrictions on the person's lifestyle.

Quality of Life

Implantable cardioverter defibrillators have demonstrated clear life-saving benefits but concerns about patient acceptance and psychological adjustment to the ICD have been the focus of much research.[8] Researchers including those from the field of cardiac psychology have concluded that the QoL of ICD patients is at least equal to, or better than those taking anti-arrhythmic medications.[9] The largest study of examined 2,521 patients with stable heart failure in the SCD-HeFT trial.[10] Results indicated that there were no differences between ICD treated and medication-treated groups at 30 months in patient reported QoL.[11] Psychological adjustment following ICD implantation has also been well-studied. Anxiety is a common psychological side effect with approximately 13-38% of ICD patients reporting clinically significant anxiety.[12][13] The primary etiological factors contributing to anxiety in ICD patients has not been determined, however. Depressive symptoms are also common but incidence of these problems have shown to be similar to those observed in other cardiac patient groups with approximately 24-41% of patients with ICDs experiencing depressive symptoms.[13]

Problems in psychosocial adjustment to ICDs, including the experience of anxiety, among spouses or other romantic partners are also prevalent[14]. This phenomenon may be related, at least in part, to shared shock anxiety and avoidance of physical and sexual contact [15].

Physical activities

Almost all forms of physical activities can be performed by patients with an ICD. All forms of sports that do not pose a risk of damaging the ICD can be enjoyed by the patient. Special care should be placed not to put excessive strain on the shoulder, arm and torso area where the ICD is implanted. Doing so may damage the ICD or the leads going from the unit to the patient's heart.

Electronic equipment

As a general rule, all electronic equipment is safe to use for patients with an ICD if kept at relative small distance from the unit. Most electronic equipment such as cellphones, Devices that generate radio waves or radio interference should be kept at least 15 centimetres (6 in) from the ICD.[16]

Electronic equipment used in a professional environment or equipment using large magnets or generating magnetic fields must be avoided by patients with an ICD. Both the magnetic fields and the EMI (Electromagnetic Interference) in an MRI scanner can interfere with the correct working of the ICD. As with other metallic objects, an ICD is a contraindication to the use of magnetic resonance imaging. Experiments are on the way for solving this kind of problem. For example Medtronic showed interesting results with a pacemaker.[17]

Clinical trials

A number of clinical trials have demonstrated the superiority of the ICD over AAD (antiarrhythmic drugs) in the prevention of death from malignant arrhythmias. The SCD-HeFT trial (published in 2005) showed a significant all-cause mortality benefit for patients with ICD. Congestive heart failure patients that were implanted with an ICD had an all-cause death risk 23% lower than placebo and an absolute decrease in mortality of 7.2 percentage points after five years in the overall population.1 Reporting in 1999, the Antiarrhythmics Versus Implantable Defibrillators (AVID) trial consisted of 1,016 patients, and deaths in those treated with AAD were more frequent (n=122) compared with deaths in the ICD groups (n=80, p < 0.001)[3]. In 2002 the MADITII trial showed benefit of ICD treatment in patients after myocardial infarction with reduced left ventricular function (EF<30).

Initially ICDs were implanted via thoracotomy with defibrillator patches applied to the epicardium or pericardium. The device was attached via subcutaneous and transvenous leads to the device contained in a subcutaneous abdominal wall pocket. The device itself acts as an electrode. Most ICDs nowadays are implanted transvenously with the devices placed in the left pectoral region similar to pacemakers. Intravascular spring or coil electrodes are used to defibrillate. The devices have become smaller and less invasive as the technology advances. Current ICDs weigh only 70 grams and are about 12.9 mm thick.

A recent study by Birnie et al. at the University of Ottawa Heart Institute has demonstrated that ICDs are underused in both the United States and Canada.[18] An accompanying editorial by Dr. Chris Simpson of Queen's University explores some of the economic, geographic, social and political reasons for this.[19]

2008 ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities (DO NOT EDIT)[20]

Implantable Cardioverter-Defibrillators[20]

Class I
"1. ICD therapy is indicated in patients who are survivors of cardiac arrest due to ventricular fibrillation or hemodynamically unstable sustained VT after evaluation to define the cause of the event and to exclude any completely reversible causes.[21][22][23][24][25][26][27] (Level of Evidence: A)"
"2. ICD therapy is indicated in patients with structural heart disease and spontaneous sustained VT, whether hemodynamically stable or unstable.[21][22][23][24][25][26][27] (Level of Evidence: B)"
"3. ICD therapy is indicated in patients with syncope of undetermined origin with clinically relevant, hemodynamically significant sustained VT or ventricular fibrillation induced at electrophysiological study.[21][25] (Level of Evidence: B)"
"4. ICD therapy is indicated in patients with LVEF less than or equal to 35% due to prior myocardial infarction who are at least 40 days post–myocardial infarction and are in NYHA functional Class II or III.[21][28] (Level of Evidence: A)"
"5. ICD therapy is indicated in patients with nonischemic dilated cardiomyopathy who have an LVEF less than or equal to 35% and who are in NYHA functional Class II or III.[21][28][29][30] (Level of Evidence: B)"
"6. ICD therapy is indicated in patients with LV dysfunction due to prior myocardial infarction who are at least 40 days post- myocardial infarction, have an LVEF less than or equal to 30%, and are in NYHA functional Class I.[21][31] (Level of Evidence: A)"
"7. ICD therapy is indicated in patients with nonsustained VT due to prior myocardial infarction, LVEF less than or equal to40%, and inducible ventricular fibrillation or sustained VT at electrophysiological study.[21][32][33] (Level of Evidence: B)"
Class III (No Benefit)
"1. ICD therapy is not indicated for patients who do not have a reasonable expectation of survival with an acceptable functional status for at least 1 year, even if they meet ICD implantation criteria specified in the Class I, IIa, and IIb recommendations above. (Level of Evidence: C)"
"2. ICD therapy is not indicated for patients with incessant VT or ventricular fibrillation. (Level of Evidence: C)"
"3. ICD therapy is not indicated in patients with significant psychiatric illnesses that may be aggravated by device implantation or that may preclude systematic follow-up. (Level of Evidence: C)"
"4. ICD therapy is not indicated for NYHA Class IV patients with drug-refractory congestive heart failure who are not candidates for cardiac transplantation or CRT-D. (Level of Evidence: C)"
"5. ICD therapy is not indicated for syncope of undetermined cause in a patient without inducible ventricular tachyarrhythmias and without structural heart disease. (Level of Evidence: C)"
"6. ICD therapy is not indicated when VF or VT is amenable to surgical or catheter ablation (e.g., atrial arrhythmias associated with the Wolff-Parkinson-White syndrome, RV or LV outflow tract VT, idiopathic VT, or fascicular VT in the absence of structural heart disease). (Level of Evidence: C)"
"7. ICD therapy is not indicated for patients with ventricular tachyarrhythmias due to a completely reversible disorder in the absence of structural heart disease (e.g., electrolyte imbalance, drugs, or trauma).[21] (Level of Evidence: B)"
Class IIa
"1. ICD implantation is reasonable for patients with unexplained syncope, significant LV dysfunction, and nonischemic DCM. (Level of Evidence: C)"
"2. ICD implantation is reasonable for patients with sustained VT and normal or near-normal ventricular function. (Level of Evidence: C)"
"3. ICD implantation is reasonable for patients with HCM who have 1 or more major{dagger} risk factors for SCD. (Level of Evidence: C)"
"4. ICD implantation is reasonable for the prevention of SCD in patients with ARVD/C who have 1 or more risk factors for SCD. (Level of Evidence: C)"
"5. ICD implantation is reasonable to reduce SCD in patients with long-QT syndrome who are experiencing syncope and/or VT while receiving beta blockers.[34][35][36][37][38][39] (Level of Evidence: B)"
"6. ICD implantation is reasonable for non hospitalized patients awaiting transplantation. (Level of Evidence: C)"
"7. ICD implantation is reasonable for patients with Brugada syndrome who have had syncope. (Level of Evidence: C)"
"8. ICD implantation is reasonable for patients with Brugada syndrome who have documented VT that has not resulted in cardiac arrest. (Level of Evidence: C)"
"9. ICD implantation is reasonable for patients with catecholaminergic polymorphic VT who have syncope and/or documented sustained VT while receiving beta blockers. (Level of Evidence: C)"
"10. ICD implantation is reasonable for patients with cardiac sarcoidosis, giant cell myocarditis, or Chagas disease. (Level of Evidence: C)"
Class IIb
"1. ICD therapy may be considered in patients with nonischemic heart disease who have an LVEF of less than or equal to 35% and who are in NYHA functional Class I. (Level of Evidence: C)"
"2. ICD therapy may be considered for patients with long-QT syndrome and risk factors for SCD.[21][34][35][36][37][38][39] (Level of Evidence: B)"
"3. ICD therapy may be considered in patients with syncope and advanced structural heart disease in whom thorough invasive and noninvasive investigations have failed to define a cause. (Level of Evidence: C)"
"4. ICD therapy may be considered in patients with a familial cardiomyopathy associated with sudden death. (Level of Evidence: C)"
"5. ICD therapy may be considered in patients with LV noncompaction. (Level of Evidence: C)"

Implantable Cardioverter-Defibrillators in Pediatric Patients and Patients With Congenital Heart Disease[20]

Class I
"1. ICD implantation is indicated in the survivor of cardiac arrest after evaluation to define the cause of the event and to exclude any reversible causes.[40][41][42][43] (Level of Evidence: B)"
"2. ICD implantation is indicated for patients with symptomatic sustained VT in association with congenital heart disease who have undergone hemodynamic and electrophysiological evaluation. Catheter ablation or surgical repair may offer possible alternatives in carefully selected patients.[44] (Level of Evidence: C)"
Class III (No Benefit)

"1. All Class III recommendations found in Section 3, "Indications for Implantable Cardioverter-Defibrillator Therapy," apply to pediatric patients and patients with congenital heart disease, and ICD implantation is not indicated in these patient populations. (Level of Evidence: C)"

Class IIa

"1. ICD implantation is reasonable for patients with congenital heart disease with recurrent syncope of undetermined origin in the presence of either ventricular dysfunction or inducible ventricular arrhythmias at electrophysiological study.[45][46] (Level of Evidence: B)"

Class IIb

"1. ICD implantation may be considered for patients with recurrent syncope associated with complex congenital heart disease and advanced systemic ventricular dysfunction when thorough invasive and noninvasive investigations have failed to define a cause.[47][48] (Level of Evidence: C)"

HRS/ACC/AHA Expert Consensus Statement on the Use of Implantable Cardioverter-Defibrillator Therapy in Patients Who Are Not Included or Not Well Represented in Clinical Trials

ICD IMPLANTATION IN THE CONTEXT OF AN ABNORMAL TROPONIN THAT IS NOT DUE TO A MYOCARDIAL INFARCTION

Patients with an abnormal troponin level (or other biomarker for myocardial infarction) who do not fulfill criteria for MI, and previously satisfied primary prevention or secondary prevention criteria for ICD implantation

Recommended
"1. In patients with abnormal cardiac biomarkers that are not thought to be due to an MI and who otherwise would be candidates for implantation on the basis of primary prevention or secondary prevention criteria, implantation of an ICD is recommended."
"2. INSERT SECOND RECOMMENDATION HERE"
Not Recommended

"1. INSERT FIRST NOT RECOMMENDED HERE"

Can be Used

"1. INSERT YOUR CAN BE USED HERE"

May be Used

"1. INSERT YOUR MAY BE USED HERE"

ICD IMPLANTATION WITHIN 40 DAYS OF A MYOCARDIAL INFARCTION

Patients within 40 days of acute MI who have known left ventricular dysfunction and who have previously satisfied criteria for implantation of a primary prevention ICD

Not Recommended

"1. Implantation of an ICD within the first 40 days following acute MI in patients with preexisting systolic ventricular dysfunction (who would have qualified for a primary prevention ICD) is not recommended. "

Patients within 40 days of an acute MI who also have an indication for permanent pacemaker implantation

Recommended
"1. In patients who, within 40 days of an MI, require nonelective permanent pacing, who also would meet primary prevention criteria for implantation of an ICD, and recovery of left ventricular function is uncertain or not expected, implantation of an ICD with appropriately selected pacing capabilities is recommended."

Patients within 40 days of an MI who subsequently present sustained or hemodynamically significant ventricular tachyarrhythmias

Recommended
"1.In patients who, within 40 days of an MI, develop sustained (or hemodynamically significant ventricular tachyarrhythmias >48 hours after an MI and in the absence of ongoing ischemia, implantation of an ICD is recommended. "
Not Recommended

"1. In patients who, within 40 days of an MI, develop sustained (or hemodynamically significant) ventricular tachyarrhythmias where there is clear evidence of an ischemic etiology with coronary anatomy amenable to revascularization (and appropriately treated), implan- tation of an ICD is not recommended."

Can be Useful

"1. In patients who, within 40 days of an MI, develop sustained (or hemodynamically significant) VT >48 hours after an MI that can be treated by ablation, implantation of an ICD can be useful."

Patients who, within 40 days of an MI (but >48 hours), present with syncope likely due to ventricular tachyarrhythmia, and in whom there is no evidence of ongoing ischemia

Can be Useful

"1. In patients who, within 40 days of an MI, present with syncope that is thought to be due to ventricular tachyarrhythmia (by clinical history, documented NSVT, or electrophysiologic study), implantation of an ICD can be useful."

Patients within 40 days of an MI who have a previously implanted ICD that requires elective replacement for battery depletion

Recommended
"1. In patients within 40 days of an MI and who have an ICD that requires elective replacement due to battery depletion, after careful assessment of comorbidities and the current clinical situation, replacement of the ICD generator is recommended."

Patients with significant left ventricular dysfunction within 40 days following an acute MI who are also listed for heart transplantation or who undergo implantation of a left ventricular assist device

Not Recommended

"1. ICD implantation in patients within 40 days of an MI who have been listed for heart transplant or implanted with a left ventricular assist device is not recommended."

ICD IMPLANTATION WITHIN 90 DAYS OF REVASCULARIZATION

Patients within 90 days of revascularization who have known left ventricular dys- function and who have previously satisfied criteria for implantation of a primary prevention ICD

Can be Useful

"1. In patients who are within 90 days of revascularization and who previously qualified for the implantation of an ICD for primary prevention of sudden cardiac death, and who have undergone revascularization that is unlikely to result in an improvement in LVEF >0.35, and who are not within 40 days after an acute MI, implantation of an ICD can be useful."

Patients within 90 days of revascularization who have previously satisfied criteria for implantation of a secondary prevention ICD (resuscitated from cardiac arrest due to VT/VF)

Recommended
"1. In patients within 90 days of revascularization who have previously qualified for the implantation of an ICD for secondary prevention of sudden cardiac death (resuscitated from cardiac arrest due to ventricular tachyarrhythmia) and have abnormal left ventricular function, implantation of an ICD is recommended."
"2. In patients within 90 days of revascularization who have previously qualified for the implantation of an ICD for secondary prevention of sudden cardiac death (resuscitated from cardiac arrest due to ventricular tachyarrhythmia) that is unlikely related to myocardial ischemia/injury and have normal left ventricular function, implantation of an ICD is recommended."
Can be Useful

"1. In patients within 90 days of revascularization who have previously qualified for the implantation of an ICD for secondary prevention of sudden cardiac death (resuscitated from cardiac arrest due to ventricular tachyarrhythmia) that was not related to acute myo- cardial ischemia/injury and who were subsequently found to have coronary artery disease that is revascularized with normal left ventricular function, implantation of an ICD can be useful."

Patients within 90 days of revascularization who also have an indication for PPM implantation

Recommended
"1. In patients within 90 days of revascularization who require nonelective permanent pacing, who would also meet primary prevention criteria for implantation of an ICD, and in whom recovery of left ventricular function is uncertain or not expected, implantation of an ICD with appropriately selected pacing capabilities is recommended."

Patients within 90 days of revascularization who subsequently present sustained or hemodynamically significant ventricular tachyarrhythmia

Recommended
"1. In patients within 90 days of revascularization with structural heart disease and sustained (or hemo- dynamically significant) ventricular tachyarrhythmia that was not clearly related to acute myocardial infarction or ischemia, implantation of an ICD is recommended. "
Can be Useful

"1. In patients who, within 90 days of revascularization, develop sustained (or hemodynamically significant) VT that can be treated by ablation therapy, implantation of an ICD can be useful."

Patients within 90 days of revascularization who present with syncope likely due to ventricular tachyarrhythmia

Can be Useful

"1. In patients within 90 days of revascularization present with syncope that is thought to be due to ventricular tachyarrhythmia (by clinical history or documented NSVT, or EP study), implantation of an ICD can be useful."

=Patients within 90 days of revascularization who have a previously implanted ICD that requires elective replacement due to battery depletion

Recommended
"1. In patients within 90 days of revascularization with an ICD that requires replacement due to battery depletion, after careful assessment of comorbidities and the cur- rent clinical situation, replacement of the ICD generator is recommended."

Patients within 90 days of revascularization who are also listed for heart trans- plantation or who undergo implantation of a ventricular assist device

Can be Useful

"1. In patients within 90 days of revascularization who have been listed for heart transplant or implanted with a ventricular assist device, and who are not within 40 days of an acute myocardial infarction, implantation of an ICD can be useful."

Sources

  • ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons [20]
  • ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/NASPE Committee to Update the 1998 Pacemaker Guidelines) [49]
  • ACC/AHA Guidelines for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices: Executive Summary--a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Pacemaker Implantation) [50]

Related Chapters

References

  1. Bardy, Gust H. (2010). "An Entirely Subcutaneous Implantable Cardioverter–Defibrillator". New England Journal of Medicine. doi:PMID: 20463331 Check |doi= value (help). Retrieved 13 May 2010. Unknown parameter |coauthors= ignored (help); Unknown parameter |month= ignored (help)
  2. Mirowski M, Mower MM, Staewen WS, et al: Standby automatic defibrillator: An approach to prevention of sudden coronary death. Arch Intern Med 126:158-161, 1970
  3. Sandoe JA, Barlow G, Chambers JB, Gammage M, Guleri A, Howard P; et al. (2015). "Guidelines for the diagnosis, prevention and management of implantable cardiac electronic device infection. Report of a joint Working Party project on behalf of the British Society for Antimicrobial Chemotherapy (BSAC, host organization), British Heart Rhythm Society (BHRS), British Cardiovascular Society (BCS), British Heart Valve Society (BHVS) and British Society for Echocardiography (BSE)". J Antimicrob Chemother. 70 (2): 325–59. doi:10.1093/jac/dku383. PMID 25355810.
  4. Harrison JL, Prendergast BD, Sandoe JA (2015). "Guidelines for the diagnosis, management and prevention of implantable cardiac electronic device infection". Heart. 101 (4): 250–2. doi:10.1136/heartjnl-2014-306873. PMID 25550318.
  5. Baddour LM, Epstein AE, Erickson CC, Knight BP, Levison ME, Lockhart PB; et al. (2010). "Update on cardiovascular implantable electronic device infections and their management: a scientific statement from the American Heart Association". Circulation. 121 (3): 458–77. doi:10.1161/CIRCULATIONAHA.109.192665. PMID 20048212.
  6. Baddour, L. M.; Epstein, A. E.; Erickson, C. C.; Knight, B. P.; Levison, M. E.; Lockhart, P. B.; Masoudi, F. A.; Okum, E. J.; Wilson, W. R.; Beerman, L. B.; Bolger, A. F.; Estes, N. A. M.; Gewitz, M.; Newburger, J. W.; Schron, E. B.; Taubert, K. A. (2010). "Update on Cardiovascular Implantable Electronic Device Infections and Their Management: A Scientific Statement From the American Heart Association". Circulation. 121 (3): 458–477. doi:10.1161/CIRCULATIONAHA.109.192665. ISSN 0009-7322.
  7. 7.0 7.1 Sohail, Muhammad R.; Uslan, Daniel Z.; Khan, Akbar H.; Friedman, Paul A.; Hayes, David L.; Wilson, Walter R.; Steckelberg, James M.; Stoner, Sarah; Baddour, Larry M. (2007). "Management and Outcome of Permanent Pacemaker and Implantable Cardioverter-Defibrillator Infections". Journal of the American College of Cardiology. 49 (18): 1851–1859. doi:10.1016/j.jacc.2007.01.072. ISSN 0735-1097.
  8. Burns JL, Serber ER, Keim S, Sears SF. Measuring patient acceptance of implantable cardiac device therapy: initial psychometric investigation of the Florida Patient Acceptance Survey. J Cardiovasc Electrophysiol 2005;16:384-390.
  9. Sears S, Matchett M, Conti J. Effective management of ICD patient psychosocial issues and patient critical events. J Cardiovasc Electrophysiol 2009;20(11):1297-304
  10. Bardy, Lee, Mark et al., 2005
  11. Mark DB, Anstrom KJ, Sun JL, Clapp-Channing NE, Tsiatis AA, Davidson-Ray L, Lee KL, Bardy GH. Quality of life with defibrillator therapy or amiodarone in heart failure. N Engl J Med 2008; 359(10):999-1008
  12. Bilge AK, Ozben B, Demircan S, et al. Depression and anxiety status of patients with implantable cardioverter defibrillator and precipitating factors. Pacing Clin Electrophysiol. 2006 Jun;29(6):619-26
  13. 13.0 13.1 Sears SF, Jr., Todaro JF, Lewis TS, Sotile W, Conti JB. Examining the psychosocial impact of implantable cardioverter defibrillators: a literature review. Clin Cardiol 1999;22:481-489
  14. Vasquez-Sowell L, Sears SF, Walker RL, Kuhl EA, Conti JB. Anxiety and marital adjustment in patients with Implantable Cardioverter Defibrillator and their spouses. Journal of Cardiopulmonary Rehabilitation and Prevention 2007;27:46-49
  15. Vasquez LD, Sears SF, Shea JB, Vasquez PM. Sexual health for patients with an Implantable Cardioverter Defibrillator. Circulation 2010;122:465-467
  16. Medtronic Patient Website FAQ: Can magnets affect my device? [1]
  17. http://wwwp.medtronic.com/Newsroom/NewsReleaseDetails.do?itemId=1242305667391&format=print&lang=en_US
  18. Birnie, David H (2007). "Use of implantable cardioverter defibrillators in Canadian and IS survivors of out-of-hospital cardiac arrest". Canadian Medical Association Journal. 177 (1): 41. doi:10.1503/cmaj.060730. PMC 1896034. PMID 17606938. Retrieved 2007-07-29. Unknown parameter |month= ignored (help); Unknown parameter |coauthors= ignored (help)
  19. Simpson, Christopher S (2007). "Implantable cardioverter defibrillators work - so why aren't we using them?". Canadian Medical Association Journal. 177 (1): 49. doi:10.1503/cmaj.070470. PMC 1896028. PMID 17606939. Retrieved 2007-07-29. Unknown parameter |month= ignored (help)
  20. 20.0 20.1 20.2 20.3 Epstein AE, DiMarco JP, Ellenbogen KA; et al. (2008). "ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices): developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons". Circulation. 117 (21): e350–408. PMID 18483207. Text "doi:10.1161/CIRCUALTIONAHA.108.189742 " ignored (help); Unknown parameter |month= ignored (help)
  21. 21.0 21.1 21.2 21.3 21.4 21.5 21.6 21.7 21.8 European Heart Rhythm Association. Heart Rhythm Society. Zipes DP, Camm AJ, Borggrefe M, Buxton AE; et al. (2006). "ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death)". J Am Coll Cardiol. 48 (5): e247–346. doi:10.1016/j.jacc.2006.07.010. PMID 16949478.
  22. 22.0 22.1 "A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. The Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators". N Engl J Med. 337 (22): 1576–83. 1997. doi:10.1056/NEJM199711273372202. PMID 9411221.
  23. 23.0 23.1 Wever EF, Hauer RN, van Capelle FL, Tijssen JG, Crijns HJ, Algra A; et al. (1995). "Randomized study of implantable defibrillator as first-choice therapy versus conventional strategy in postinfarct sudden death survivors". Circulation. 91 (8): 2195–203. PMID 7697849.
  24. 24.0 24.1 Siebels J, Kuck KH (1994). "Implantable cardioverter defibrillator compared with antiarrhythmic drug treatment in cardiac arrest survivors (the Cardiac Arrest Study Hamburg)". Am Heart J. 127 (4 Pt 2): 1139–44. PMID 8160593.
  25. 25.0 25.1 25.2 Connolly SJ, Gent M, Roberts RS, Dorian P, Roy D, Sheldon RS; et al. (2000). "Canadian implantable defibrillator study (CIDS) : a randomized trial of the implantable cardioverter defibrillator against amiodarone". Circulation. 101 (11): 1297–302. PMID 10725290.
  26. 26.0 26.1 Kuck KH, Cappato R, Siebels J, Rüppel R (2000). "Randomized comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from cardiac arrest : the Cardiac Arrest Study Hamburg (CASH)". Circulation. 102 (7): 748–54. PMID 10942742.
  27. 27.0 27.1 Connolly SJ, Hallstrom AP, Cappato R, Schron EB, Kuck KH, Zipes DP; et al. (2000). "Meta-analysis of the implantable cardioverter defibrillator secondary prevention trials. AVID, CASH and CIDS studies. Antiarrhythmics vs Implantable Defibrillator study. Cardiac Arrest Study Hamburg . Canadian Implantable Defibrillator Study". Eur Heart J. 21 (24): 2071–8. doi:10.1053/euhj.2000.2476. PMID 11102258.
  28. 28.0 28.1 Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, Boineau R; et al. (2005). "Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure". N Engl J Med. 352 (3): 225–37. doi:10.1056/NEJMoa043399. PMID 15659722. Review in: ACP J Club. 2005 Jul-Aug;143(1):6
  29. Kadish A, Dyer A, Daubert JP, Quigg R, Estes NA, Anderson KP; et al. (2004). "Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy". N Engl J Med. 350 (21): 2151–8. doi:10.1056/NEJMoa033088. PMID 15152060. Review in: ACP J Club. 2004 Nov-Dec;141(3):61
  30. Desai AS, Fang JC, Maisel WH, Baughman KL (2004). "Implantable defibrillators for the prevention of mortality in patients with nonischemic cardiomyopathy: a meta-analysis of randomized controlled trials". JAMA. 292 (23): 2874–9. doi:10.1001/jama.292.23.2874. PMID 15598919. Review in: ACP J Club. 2005 May-Jun;142(3):57
  31. Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS; et al. (2002). "Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction". N Engl J Med. 346 (12): 877–83. doi:10.1056/NEJMoa013474. PMID 11907286. Review in: ACP J Club. 2002 Nov-Dec;137(3):81
  32. Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EN, Hafley G (1999). "A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators". N Engl J Med. 341 (25): 1882–90. doi:10.1056/NEJM199912163412503. PMID 10601507.
  33. Moss AJ, Hall WJ, Cannom DS, Daubert JP, Higgins SL, Klein H; et al. (1996). "Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators". N Engl J Med. 335 (26): 1933–40. doi:10.1056/NEJM199612263352601. PMID 8960472.
  34. 34.0 34.1 Zareba W, Moss AJ, Daubert JP, Hall WJ, Robinson JL, Andrews M (2003). "Implantable cardioverter defibrillator in high-risk long QT syndrome patients". J Cardiovasc Electrophysiol. 14 (4): 337–41. PMID 12741701.
  35. 35.0 35.1 Viskin S (2003). "Implantable cardioverter defibrillator in high-risk long QT syndrome patients". J Cardiovasc Electrophysiol. 14 (10): 1130–1, reply 1131. PMID 14521674.
  36. 36.0 36.1 Goel AK, Berger S, Pelech A, Dhala A (2004). "Implantable cardioverter defibrillator therapy in children with long QT syndrome". Pediatr Cardiol. 25 (4): 370–8. doi:10.1007/s00246-003-0566-4. PMID 14994181.
  37. 37.0 37.1 Mönnig G, Köbe J, Löher A, Eckardt L, Wedekind H, Scheld HH; et al. (2005). "Implantable cardioverter-defibrillator therapy in patients with congenital long-QT syndrome: a long-term follow-up". Heart Rhythm. 2 (5): 497–504. doi:10.1016/j.hrthm.2005.02.008. PMID 15840474.
  38. 38.0 38.1 Goldenberg I, Mathew J, Moss AJ, McNitt S, Peterson DR, Zareba W; et al. (2006). "Corrected QT variability in serial electrocardiograms in long QT syndrome: the importance of the maximum corrected QT for risk stratification". J Am Coll Cardiol. 48 (5): 1047–52. doi:10.1016/j.jacc.2006.06.033. PMID 16949500.
  39. 39.0 39.1 Hobbs JB, Peterson DR, Moss AJ, McNitt S, Zareba W, Goldenberg I; et al. (2006). "Risk of aborted cardiac arrest or sudden cardiac death during adolescence in the long-QT syndrome". JAMA. 296 (10): 1249–54. doi:10.1001/jama.296.10.1249. PMID 16968849.
  40. Silka MJ, Kron J, Dunnigan A, Dick M (1993). "Sudden cardiac death and the use of implantable cardioverter-defibrillators in pediatric patients. The Pediatric Electrophysiology Society". Circulation. 87 (3): 800–7. PMID 8443901.
  41. Hamilton RM, Dorian P, Gow RM, Williams WG (1996). "Five-year experience with implantable defibrillators in children". Am J Cardiol. 77 (7): 524–6. PMID 8629596.
  42. Alexander ME, Cecchin F, Walsh EP, Triedman JK, Bevilacqua LM, Berul CI (2004). "Implications of implantable cardioverter defibrillator therapy in congenital heart disease and pediatrics". J Cardiovasc Electrophysiol. 15 (1): 72–6. doi:10.1046/j.1540-8167.2004.03388.x. PMID 15028076.
  43. Choi GR, Porter CB, Ackerman MJ (2004). "Sudden cardiac death and channelopathies: a review of implantable defibrillator therapy". Pediatr Clin North Am. 51 (5): 1289–303. doi:10.1016/j.pcl.2004.04.015. PMID 15331285.
  44. Karamlou T, Silber I, Lao R, McCrindle BW, Harris L, Downar E; et al. (2006). "Outcomes after late reoperation in patients with repaired tetralogy of Fallot: the impact of arrhythmia and arrhythmia surgery". Ann Thorac Surg. 81 (5): 1786–93, discussion 1793. doi:10.1016/j.athoracsur.2005.12.039. PMID 16631673.
  45. Mushlin AI, Hall WJ, Zwanziger J, Gajary E, Andrews M, Marron R; et al. (1998). "The cost-effectiveness of automatic implantable cardiac defibrillators: results from MADIT. Multicenter Automatic Defibrillator Implantation Trial". Circulation. 97 (21): 2129–35. PMID 9626173.
  46. Khairy P, Landzberg MJ, Gatzoulis MA, Lucron H, Lambert J, Marçon F; et al. (2004). "Value of programmed ventricular stimulation after tetralogy of fallot repair: a multicenter study". Circulation. 109 (16): 1994–2000. doi:10.1161/01.CIR.0000126495.11040.BD. PMID 15051640.
  47. Kammeraad JA, van Deurzen CH, Sreeram N, Bink-Boelkens MT, Ottenkamp J, Helbing WA; et al. (2004). "Predictors of sudden cardiac death after Mustard or Senning repair for transposition of the great arteries". J Am Coll Cardiol. 44 (5): 1095–102. doi:10.1016/j.jacc.2004.05.073. PMID 15337224.
  48. Dubin AM, Berul CI, Bevilacqua LM, Collins KK, Etheridge SP, Fenrich AL; et al. (2003). "The use of implantable cardioverter-defibrillators in pediatric patients awaiting heart transplantation". J Card Fail. 9 (5): 375–9. PMID 14583898.
  49. Gregoratos G, Abrams J, Epstein AE; et al. (2002). "ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/NASPE Committee to Update the 1998 Pacemaker Guidelines)". Circulation. 106 (16): 2145–61. PMID 12379588. Text "doi:10.1161/01.CIR.0000035996.46455.09 " ignored (help); Unknown parameter |month= ignored (help)
  50. Gregoratos G, Cheitlin MD, Conill A; et al. (1998). "ACC/AHA Guidelines for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices: Executive Summary--a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Pacemaker Implantation)". Circulation. 97 (13): 1325–35. PMID 9570207. Unknown parameter |month= ignored (help)

Template:Emergency medicine

de:Implantierbarer Kardioverter-Defibrillator


Template:WikiDoc Sources