Role of “Single Shock” ICD for Primary Prevention of Sudden Death in Heart Failure Patients

  • J. Brachmann
Conference paper


When implantable cardioverter defibrillators (ICDs) were first introduced, ICD therapy was offered only to those patients who already had experienced an episode of ventricular fibrillation (VF). The dilemma of this approach in the particular field of ICD therapy, however, is that only a few per cent of patients survive their first VF episode. In other words, only a few thousand out of the400 000annual victims of sudden cardiac death in the USA have the chance to be treated with an ICD [1,2].However, if patients at an elevated risk were identifiedbeforethey have their first VF episode and were implanted with an ICD prophylactically, the incidence of sudden cardiac death could be reduced.


Sudden Cardiac Death Ventricular Fibrillation Heart Failure Patient Implantable Cardioverter Defibrillator Single Shock 
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.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Engelstein ED, Zipes DP (1998) Sudden cardiac death. In: Alexander RW, Schlant RC, Fuster V (eds) The heart, arteries and veins. McGraw-Hill, New York, pp 1081–1112Google Scholar
  2. 2.
    Myerburg RJ, Castellanos A (1997) Cardiac arrest and sudden death. In: Braunwald E (ed) Heart disease: a textbook of cardiovascular medicine. WB Saunders, Philadelphia, pp 742–779Google Scholar
  3. 3.
    Buxton AE, Lee KL, Fisher JD et al (1999) A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial investigators. N Engl J Med 341:1882–1890PubMedCrossRefGoogle Scholar
  4. 4.
    Bigger JT Jr (1997) Prophylactic use of implanted cardiac defibrillators in patients at high risk for ventricular arrhythmias after coronary-artery bypass graft surgery. Coronary Artery Bypass Graft (CABG) Patch trial investigators. N Engl J Med 337:1569–1575PubMedCrossRefGoogle Scholar
  5. 5.
    Bansch D, Antz M, Boczor S et al (2002) Primary prevention of sudden cardiac death in idiopathic dilated cardiomyopathy: the Cardiomyopathy Trial (CAT). Circulation 105:1453–1458PubMedCrossRefGoogle Scholar
  6. 6.
    Higgins SL, Klein H, Nisam S (1997) Which device should “MADIT protocol” patients receive? Multicenter Automatic Defibrillator Implantation Trial. Am J Cardiol 79:3135CrossRefGoogle Scholar
  7. 7.
    Zipes DP (2001) Implantable cardioverter-defibrillator: a Volkswagen or a Rolls Royce: how much will we pay to save a life? Circulation 103:1372–1374PubMedCrossRefGoogle Scholar
  8. 8.
    Moss AJ, Zareba W, Hall WJ et al (2002) Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med 346:877–883PubMedCrossRefGoogle Scholar
  9. 9.
    MADIT II. FDA Premarket Approval Application: summary of safety and effectiveness. 2; P910077/S037 and P960040/S026.
  10. 10.
    Anonymous (1997) A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. The Antiarrhythmics Versus Implantable Defibrillators (AVID) Investigators. N Engl J Med 337:1576–1583CrossRefGoogle Scholar
  11. 11.
    Connolly SJ, Gent M, Roberts RS et al (2000) Canadian implantable defibrillator study (CIDS): a randomized trial of the implantable cardioverter defibrillator against amiodarone. Circulation 101:1297–1302PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2003

Authors and Affiliations

  • J. Brachmann
    • 1
  1. 1.Department of Cardiology Klinikum CoburgUniversity of WürzburgCoburgGermany

Personalised recommendations