Managing patients with ICD shocks and programming tachycardia therapies during acute heart failure syndromes
Jason Bradfield1, Roderick Tung, Noel G Boyle
1UCLA Cardiac Arrhythmia Center, Ronald Reagan UCLA Medical Center, David Geffen School of Medicine at UCLA, A2-237 CHS, 650 Charles E. Young Drive South, Los Angeles, CA 90095-1679, USA. JBradfield@mednet.ucla.edu
Heart Failure Reviews
|April 1, 2011
Insights
Patients with implantable cardioverter-defibrillators experiencing acute heart failure and shocks have treatment options. This review covers pharmacologic, interventional, and device programming strategies.
Area of Science:
- Cardiology
- Medical Devices
Background:
- Acute heart failure is a common complication in patients with implantable cardioverter-defibrillators (ICDs).
- ICD shocks in the setting of acute heart failure can be distressing and require prompt management.
Purpose of the Study:
- To review current treatment strategies for patients experiencing acute heart failure and ICD shocks.
- To provide an overview of pharmacologic, interventional, and device programming options.
Main Methods:
- Literature review of existing studies and guidelines.
- Synthesis of evidence regarding management of acute heart failure in ICD patients with shocks.
Main Results:
- Pharmacologic therapies may include diuretics, vasodilators, and inotropes.
- Interventional options might involve optimization of cardiac resynchronization therapy (CRT) or consideration of mechanical circulatory support.
- Device programming adjustments can help mitigate inappropriate or appropriate shocks.
Conclusions:
- A multidisciplinary approach is crucial for managing these complex patients.
- Tailoring treatment based on the underlying cause of heart failure and shock burden is essential.
- Optimizing medical therapy and device function can improve outcomes.
Abstract:
We review the pharmacologic, interventional and device programming treatment options for patients with implantable cardioverter-defibrillators who present with acute heart failure and implantable cardioverter-defibrillator shocks.
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