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Implantable cardioverter-defibrillator: present and future indications
M Block1, H Scheld, G Breithardt
1Department of Cardiology-Angiology, Hospital of the Westfälische Wilhelms-University of Münster, Germany.
Archives Des Maladies Du Coeur Et Des Vaisseaux
|February 1, 1996
Summary
Indications for implantable cardioverter-defibrillators (ICDs) have evolved, expanding their use in ventricular tachyarrhythmias. ICDs are now a first-line therapy, offering improved survival and quality of life.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Device Technology
Background:
- Guidelines for automatic cardioverter-defibrillators (ICDs) have evolved since 1991.
- Less invasive procedures and improved device technology have reduced mortality and improved patient quality of life.
- The efficacy of antiarrhythmic drugs has led to expanded ICD indications.
Purpose of the Study:
- To review the changing indications for ICDs in patients with ventricular tachyarrhythmias.
- To highlight the role of ICDs as a first-line treatment.
- To discuss future directions and potential expansion of ICD use.
Main Methods:
- Review of historical guidelines and current clinical practice.
- Analysis of outcomes data regarding ICDs versus antiarrhythmic drugs.
- Consideration of ongoing and future research studies.
Main Results:
- ICDs are now a first-line treatment for ventricular tachyarrhythmias unrelated to acute myocardial infarction.
- ICD therapy is the gold standard for cardiac arrest survivors, demonstrating a low annual incidence of sudden death.
- Improvements in surgical approaches and device therapy have reduced perioperative mortality and shock burden.
Conclusions:
- ICD indications have significantly expanded due to improved outcomes and device efficacy.
- Ongoing studies will further refine ICD therapy recommendations for ventricular tachyarrhythmias.
- Prophylactic ICD implantation in high-risk patients may represent a future expansion of indications.