[Implantable cardioverter-defibrillator in patients with chronic heart failure].
Sudden cardiac death (SCD) is a major cause of death in patients with chronic heart failure. The implantable cardioverter-defibrillator (ICD) effectively treats malignant ventricular tachyarrhythmias and reduces significantly the total mortality as well as the incidence of SCD in heart failure patients. It is evident that ICD is indicated for the secondary prevention of SCD. There is growing evidence for the use of the ICD for the primary prevention of SCD in patients with LV systolic dysfunction without documented arrhythmia. However, the efficacy of ICD seems to be modest in patients with advanced heart failure. Individualized combined therapies such as ICD plus amiodarone and ICD plus cardiac resynchronization therapy are necessary for advanced heart failure patients. It is doubtful whether ICD is indicated for MADIT II and SCD -HeFT population in Japan, where the incidence of SCD is thought to be lower than the Western countries.
Matsuda
Naoki
N
Department of Cardiology, Tokyo Women's Medical University.