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Which Patient and when Should Receive an ICD? Evolving New Indications on the Horizon

  • Roberto Verlato
  • Maria Stella Baccillieri
  • Pietro Turrini
Conference paper

Abstract

Internal cardioverter defibrillator (ICD) therapy has come a long way since its introduction in the 1980s as the first-line treatment for the few fortunate survivors of recurrent sudden cardiac arrest (SCA). Secondary- and primary-prevention trials enrolling patients with either ischemic or nonischemic cardiomyopathy with depressed left ventricular ejection fraction (LVEF) and NYHA II–IV (AVID, CIDS, CASH, MADIT, MUSTT, MADIT II, DEFINITE) have overwhelmingly demonstrated that ICD therapy reduces total mortality compared with anti-arrhythmic drug therapy and/or optimal medical therapy [1, 2, 3, 4, 5, 6, 7]. The most recent trials (COMPANION and SCD-HeFT) [8, 9] focused on patients with NYHA class II–IV heart-failure (HF) symptoms and depressed LVEF: ICD alone or combined with a left ventricular lead for cardiac resynchronization significantly reduced total mortality as compared with optimal medical therapy (ACE inhibitors/ARB blockers, beta-blockers, canrenoate, diuretics) and amiodarone.

Keywords

Left Ventricular Ejection Fraction Brugada Syndrome Sudden Cardiac Arrest Left Ventricular Lead Implantable Defibrillator 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Italia 2007

Authors and Affiliations

  • Roberto Verlato
    • 1
  • Maria Stella Baccillieri
    • 1
  • Pietro Turrini
    • 1
  1. 1.Interventional Electrophysiology Unit, Department of CardiologyCamposampiero HospitalPaduaItaly

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