title: Implantable cardioverter-defibrillator implantation for primary and secondary prevention: indications and outcomes.
abstract: Implantable cardioverter-defibrillators effectively reduce the rate of sudden cardiac death in children. Significant efforts have been made to better characterise the indications for their placement, and over the past two decades there has been a shift in their use from secondary to primary prevention. Primary prevention includes placement in patients thought to be at high risk of sudden cardiac death before the patient experiences any event. Secondary prevention includes placement after a high-risk event including sustained ventricular tachycardia or resuscitated cardiac arrest. Although liberal device implantation may be appealing even in patients having marginal indications, studies have shown high rates of adverse effects including inappropriate device discharges and the need for re-intervention because of hardware malfunction. The indications for placement of an implantable cardioverter-defibrillator, whether for primary or secondary prevention of sudden cardiac death, vary based on cardiac pathology. This review will assist the provider in understanding the risks and benefits of device implantation in order to enhance the shared decision-making capacity of patients, families, and providers.
authors.affiliation: Children's Hospital of Orange County,University of California Irvine,Irvine, California,United States of America.
authors.forename: Justin M
authors.initials: JM
authors.lastname: Pick
authors.affiliation: Children's Hospital of Orange County,University of California Irvine,Irvine, California,United States of America.
authors.forename: Anjan S
authors.initials: AS
authors.lastname: Batra
mesh_terms: D002312:Cardiomyopathy, Hypertrophic / Q000150:complications; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D004868:Equipment Failure; D006801:Humans; D011322:Primary Prevention; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention; D017180:Tachycardia, Ventricular / Q000150:complications
keywords: Implantable cardioverter-defibrillator; primary prevention; secondary prevention; sudden cardiac death