Implantable Cardioverter-Defibrillator for Primary Prevention in Asia

Area of Science:

• Cardiology
• Medical Technology
• Public Health

Background:

• Sudden cardiac death (SCD) risk is low in contemporary settings, complicated by improved heart failure management and advanced technology.
• Significant disparities exist in implantable cardioverter-defibrillator (ICD) utilization between Asia and Western countries, despite lower SCD prevalence in Asia.
• Underutilization of ICDs in resource-limited regions necessitates tailored approaches for primary SCD prevention.

Purpose of the Study:

• To review current knowledge on ICD therapy for primary prevention of SCD.
• To identify strategies for optimizing patient and device selection for ICD implantation.
• To address the challenges in ICD utilization, particularly in Asian populations and resource-limited settings.

Main Methods:

• Literature review of current research on ICD therapy for SCD prevention.
• Analysis of epidemiological data on SCD prevalence and ICD utilization globally, with a focus on Asia.
• Discussion of factors influencing patient and device selection for ICDs.

Main Results:

• Identifying optimal candidates for primary prevention ICDs remains a challenge due to low event rates and advanced therapies.
• Significant underutilization of ICDs in Asia (∼12%) compared to Western countries (∼45%) is evident.
• Regional variations and limited resources contribute to the gap in ICD use, highlighting the need for individualized strategies.

Conclusions:

• An individualized approach is crucial for selecting patients who will benefit from ICDs for primary SCD prevention.
• Specific regional recommendations are needed to address the underutilization of ICDs, particularly in Asia.
• Improving patient and device selection is key to optimizing ICD therapy for SCD prevention in diverse healthcare settings.