Use of traditional and biventricular implantable cardiac devices for primary and secondary prevention of sudden death.
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.
Division of Cardiology, Medical University of South Carolina, Charleston, SC 29425, USA.
Matthew H
MH
Klein
Michael R
MR
Gold
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000628:therapy; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D006801:Humans; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology; D014693:Ventricular Fibrillation / Q000453:epidemiology
D000889:Anti-Arrhythmia Agents