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[Indications for implantable automatic defibrillators]
A Leenhardt1, P Coumel, O Thomas
1Service de cardiologie, hôpital Lariboisière, Paris.
Insights
The automatic implantable defibrillator effectively reduces sudden death in patients with severe ventricular arrhythmias. However, consensus on precise indications and long-term mortality data remains elusive, necessitating individualized therapeutic approaches.
Area of Science:
- Cardiology
- Medical Devices
- Electrophysiology
Abstract:
The automatic implantable defibrillator is an effective therapeutic tool for palliative treatment of severe ventricular arrhythmias. There is a significant reduction in sudden death in implanted patients. However, reliable data on the long term global mortality is not yet available. The indications are difficult to define apart from special cases. A large number of factors has to be taken into consideration: the clinical presentation of the arrhythmia, and the different medical and non-medical therapeutic options. At present, it is not possible to arrive at a consensus on the indications of automatic implantable defibrillators. Therefore, it is illusory to construct decisional algorithms. The authors suggest therapeutic orientations rather than strict clinical indications, based on recommendations published by the working groups on cardiac arrhythmias and pacing of the European Society of Cardiology and on their own personal experience.