Sudden cardiac death and implantable cardioverter-defibrillators.

Abstract:

:Sudden cardiac death is a major public health problem, affecting 500,000 patients in the United States annually. An implantable cardioverter-defibrillator (ICD) can terminate malignant ventricular arrhythmias and has been shown to improve survival in high-risk populations. Although sudden cardiac death is a heterogeneous condition, left ventricular ejection fraction of 35 percent or less remains the single best factor to stratify patients for prophylactic ICD implantation, and randomized trials have shown mortality benefit in this population. Therefore, in patients with heart disease, assessment of ejection fraction remains the most important step to identify patients at risk of sudden cardiac death who would benefit from ICD implantation. Physician understanding of each patient's ICD type, indication, etiology of heart disease, and cardiovascular status is essential for optimal care. If the ICD was placed for secondary prevention, the circumstances relating to the index event should be explored. Evaluation of defibrillator shocks merits careful assessment of the patient's cardiovascular status. Consultation with a subspecialist and interrogation of the ICD can determine if shocks were appropriate or inappropriate and can facilitate management.

journal_name

Am Fam Physician

authors

Turakhia MP

subject

Has Abstract

pub_date

2010-12-01 00:00:00

pages

1357-66

issue

11

eissn

0002-838X

issn

1532-0650

pii

d8527

journal_volume

82

pub_type

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