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Updated: Jun 27, 2026
A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
Risks and challenges of implantable cardioverter-defibrillators in young adults
Mark V Sherrid1, James P Daubert
1Cardiology Division, Department of Medicine, St. Luke's-Roosevelt Hospital Center, Columbia University, College of Physicians and Surgeons, New York City, NY 10019, USA. msherrid@chpnet.org
Insights
Implantable cardioverter-defibrillators (ICDs) are crucial for preventing sudden cardiac death in young patients. This review highlights the unique challenges of ICD implantation and long-term management in individuals aged 16-45.
Area of Science:
- Cardiology
- Medical Devices
- Electrophysiology
Background:
- Implantable cardioverter-defibrillators (ICDs) are established for preventing sudden death in patients with left ventricular dysfunction.
- Their use is expanding to younger patients with various structural heart diseases or primary electrophysiologic abnormalities.
- Younger patients face a longer cumulative risk and decades of living with an ICD.
Purpose of the Study:
- To review the specific challenges associated with implantable cardioverter-defibrillator (ICD) implantation in young patients (16-45 years).
- To discuss the long-term implications and management considerations for this demographic.
- To address the unique issues arising from a prolonged period of device dependency.
Main Methods:
- This is a review article.
- It synthesizes existing literature on ICD use in young populations.
- Focuses on challenges related to age, long-term device management, and potential complications.
Main Results:
- Younger patients present unique considerations for ICD implantation compared to older adults.
- Long-term risks and device-related issues may be amplified due to the extended lifespan with the device.
- Management strategies need to account for the prolonged duration of device therapy.
Conclusions:
- ICD implantation in young patients necessitates careful consideration of long-term management and potential device-related complications.
- Physicians must navigate unique challenges posed by the extended period of device dependency in this population.
- Addressing these challenges is crucial for optimizing outcomes and quality of life for young individuals with ICDs.
Abstract:
The clinical use of the implantable cardioverter-defibrillator (ICD) is well established to prevent sudden death in patients with left ventricular dysfunction due to coronary artery disease and dilated cardiomyopathy, and its use has saved thousands of lives. More recently, its use has been extended to other patients at risk for sudden cardiac arrest due to ventricular fibrillation: patients with structural heart diseases such as hypertrophic cardiomyopathy and arrhythmogenic right ventricular dysplasia and patients with normal cardiac anatomy and function except for electrophysiologic abnormalities that predispose to cardiac arrest: Brugada syndrome and long QT syndrome. A distinguishing feature of these patients may be the young age when they present for either primary or secondary prevention. This contrasts with the "first wave" of adult ICD implantations that were usually performed in elderly or middle aged patients. An important consideration in favor of ICD implantation in young patients with sudden death risk is the long and cumulative period of their risk. Similarly, after implantation, these patients will experience the long-term risks of ICD implantation. This review focuses on the unique challenges presented by device implantation in young patients 16 to 45 years of age who may have 4 to 7 decades of life with their devices. Although devices may prolong life, they come with problems that will pose unique challenges for both patients and their physicians. Moreover, because of the long durations, these problems may accelerate as patients age.
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