Related Experiment Videos
Cardioverter defibrillator therapy as a bridge to heart transplantation
1Department of Cardiology, University Hospital Hannover, Germany.
Insights
Patients with severe heart failure face high mortality, often from sudden cardiac death. Prophylactic implantation of an implantable cardioverter defibrillator (ICD) may improve survival for heart transplant candidates awaiting a donor heart.
Area of Science:
- Cardiology
- Cardiac Electrophysiology
- Transplantation Medicine
Background:
- Patients with severely impaired left ventricular function have a poor prognosis, with approximately 50% annual mortality, primarily due to sudden cardiac death.
- Sudden cardiac death is also a significant cause of mortality (around 30%) for patients with end-stage heart disease awaiting heart transplantation.
Purpose of the Study:
- To evaluate the potential benefit of prophylactic implantable cardioverter defibrillator (ICD) implantation in patients with end-stage heart disease awaiting heart transplantation.
- To determine if ICD therapy can reduce sudden cardiac death and improve survival rates in this high-risk patient population.
Main Methods:
- The study discusses the established efficacy and low surgical mortality associated with implantable cardioverter defibrillator (ICD) therapy for preventing sudden death.
- It proposes a hypothesis for prophylactic ICD use in heart transplant candidates, though prospective studies are needed for confirmation.
Main Results:
- Implantable cardioverter defibrillator (ICD) therapy is highly effective in preventing sudden cardiac death and has low surgical mortality.
- Prophylactic ICD implantation is hypothesized to prevent sudden death in end-stage heart disease patients on the transplant waiting list.
Conclusions:
- Implantable cardioverter defibrillator (ICD) therapy likely increases the chances of survival for patients awaiting a donor heart.
- Prospective studies are required to definitively prove the hypothesis that prophylactic ICD implantation improves survival in heart transplant candidates.
Abstract:
The prognosis of patients with severely impaired left ventricular function is poor, with an annual mortality rate of about 50%, and the majority die from sudden cardiac death. Heart transplantation is an accepted therapy for patients with end-stage heart disease; however, about 30% of candidates for transplantation die from sudden cardiac death while on the waiting list. It has been shown that implantable cardioverter defibrillator (ICD) therapy has a low surgical mortality and is highly effective in the prevention of sudden death. Therefore, prophylactic ICD implantation may prevent sudden death in patients with end-stage heart disease while on the waiting list, and it is highly probable that patients with an ICD have a greater chance of survival until a donor heart becomes available. However, this hypothesis still has to be proven by prospective studies.