Assessment on Implantable Defibrillators and the Evidence for Primary Prevention of Sudden Cardiac Death

Implantable cardioverter–defibrillators (ICDs) are battery-powered implantable devices that monitor heart rhythm and deliver therapy in the form of either electric shock or antitachycardia pacing (ATP) when a life-threatening ventricular arrhythmia is detected. ICDs have been used in patients who survived sustained ventricular arrhythmias to prevent sudden cardiac death (SCD). In recent years, ICDs have also been implanted for primary prevention (prevention of SCD in a patient who has not had yet had sustained ventricular tachyarrhythmia but has risk factors for it). ICDs may also include cardiac resynchronization therapy (CRT) for additional treatment of heart failure in patients with dyssynchronous ventricles. 

Key Question 1 examined ICD versus no ICD, ICD with ATP versus ICD alone, or ICD with CRT versus ICD alone, and differences among subgroups. Key Question 2 examined early and late adverse events and inappropriate shocks after ICD implantation, and differences among subgroups. Key Question 3 examined eligibility criteria and evaluation methods for patients included in comparative studies and the risk of SCD. 

Tags: defibrillator, implantable
Year: 2013