title: [Sudden cardiac death in patients with left ventricular dysfunction from ischemic heart disease: role of the implantable defibrillator. Evidence, guidelines and good clinical judgment].
abstract: A number of studies have shown that the implantable cardioverter-defibrillator (ICD) is the most effective therapy for the prevention of sudden cardiac death from ventricular arrhythmias in patients with ischemic heart disease and severe left ventricular dysfunction. However, ejection fraction should not be considered the only parameter for the identification of candidates to ICD; this may lead to a "hyper-simplification" of the choices and to often unnecessary or inappropriate implantations. The purpose of this paper was to review the literature data regarding indications for ICD implantation in primary prevention in patients with severe ischemic left ventricular dysfunction by taking into account different clinical settings, in particular the biological age, the comorbidity profile, the temporal length between the ischemic event and ICD implantation, the possible impact of revascularization in reducing the arrhythmic risk.
authors: Dipartimento Cardiovascolare e Scuola di Specializzazione in Malattie dell'Apparato Cardiovascolare, Azienda Ospedaliero-Universitaria, Ospedali Riuniti e Università degli Studi, 34129 Trieste, Italy. lavise@gmail.com
authors: Laura Vitali
authors: LV
authors: Serdoz
authors: Enrico
authors: E
authors: Fabris
authors: Cristina
authors: C
authors: Lutman
authors: Marco
authors: M
authors: Merlo
authors: Massimo
authors: M
authors: Zecchin
authors: Gianfranco
authors: G
authors: Sinagra
mesh_terms: D016757:Death, Sudden, Cardiac / Q000209:etiology* / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D019317:Evidence-Based Medicine; D006801:Humans; D017202:Myocardial Ischemia / Q000150:complications*; D017410:Practice Guidelines as Topic; D018487:Ventricular Dysfunction, Left / Q000150:complications*