Use of traditional and biventricular implantable cardiac devices for primary and secondary prevention of sudden death

• Published in: Cardiology clinics Vol. 26; no. 3; p. 419
• Main Authors: Klein, Matthew H, Gold, Michael R
• Format: Journal Article
• Language: English
• Published: Netherlands 01.08.2008
• Subjects: Anti-Arrhythmia Agents - therapeutic use; Arrhythmias, Cardiac - therapy; Cardiac Pacing, Artificial - methods; Death, Sudden, Cardiac - epidemiology; Death, Sudden, Cardiac - prevention & control; Defibrillators, Implantable; Humans; Stroke Volume; Ventricular Dysfunction, Left - epidemiology; Ventricular Fibrillation - epidemiology
• ISSN: 0733-8651
• DOI: 10.1016/j.ccl.2008.03.006

Sudden cardiac death is the leading cause of cardiac mortality, particularly among high-risk populations with known left ventricular systolic dysfunction. Multiple randomized clinical trials demonstrated a significant mortality benefit of the implantable cardioverter defibrillator (ICD) compared with antiarrhythmic drug therapy or standard medical care. Initial ICD trials showed a mortality improvement for patients who previously had experienced aborted sudden cardiac death or sustained ventricular tachycardia (secondary prevention). Primary prevention trials in selected high-risk patients who had both ischemic and nonischemic cardiomyopathy also demonstrated a mortality benefit associated with ICD treatment. More recently, cardiac resynchronization therapy with or without defibrillator capability has been shown to reduce morbidity and mortality among advanced heart failure patients with a prolonged QRS duration.