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Replacement of Implantable Cardioverter-Defibrillators When Ventricular Function Has Recovered

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Clinical Controversies in Device Therapy for Cardiac Arrhythmias

Abstract

One in three patients with an implantable cardioverter-defibrillator (ICD) for primary prevention of sudden cardiac death experiences a substantial improvement in left ventricular ejection fraction (EF) rendering them ineligible for ICD if they were presenting anew. The management of these patients may pose a challenge for the clinician, particularly when the current device reaches elective replacement indicator. In the following chapter, we review the data on this topic, including the first-ever analysis on all-cause mortality in relation to ICD among patients with EF >35%. We then provide an algorithm for the management of these patients at the time of generator replacement.

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Author notes

  1. Drs. Anand and Gutierrez have contributed equally to the manuscript.

Authors and Affiliations

  1. Cardiology Division, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA

    Selcuk Adabag

  2. Department of Cardiovascular Medicine, University of Minnesota, Minneapolis, MN, USA

    Selcuk Adabag & Alejandra Gutierrez

  3. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA

    Vidhu Anand

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  1. Selcuk Adabag
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  2. Vidhu Anand
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Correspondence to Selcuk Adabag .

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Editors and Affiliations

  1. University of Rochester School of Medicine & Dentistry/Hackensack Meridian, School of Medicine at Seton Hall, University/Summit Medical Group, Short Hills, NJ, USA

    Jonathan S. Steinberg

  2. Electrophysiology Section, Cardiovascular Division, Univeristy of Pennsylvania, and the Cardiology Division, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA

    Andrew E. Epstein

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Adabag, S., Anand, V., Gutierrez, A. (2019). Replacement of Implantable Cardioverter-Defibrillators When Ventricular Function Has Recovered. In: Steinberg, J., Epstein, A. (eds) Clinical Controversies in Device Therapy for Cardiac Arrhythmias . Springer, Cham. https://doi.org/10.1007/978-3-030-22882-8_8

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