Skip to main content
Clinical Cardiology logoLink to Clinical Cardiology
. 2007 Jan 29;30(1):3–8. doi: 10.1002/clc.20001

Implantable cardioverter defibrillators for prevention of sudden cardiac Death

Rishi Sukhija 1, Vimal Mehta 2, Marino Leonardi 1, Jawahar L Mehta 1,
PMCID: PMC6653546  PMID: 17262771

Abstract

Despite the multiple advances in the field of cardiovascular medicine, the incidence of sudden cardiac death (SCD) continues to rise. Of all SCDs, <25% occur in individuals deemed at high risk by current risk‐stratification algorithms; hence, these risk‐stratification algorithms are not satisfactory. Until better markers are identified to risk stratify patients, we will see an increasing use of implantable cardioverter defibrillators (ICDs). However, even with the increase in defibrillator use, the impact on overall incidence of SCD may only be modest, as many individuals experience SCD as the first manifestation of cardiovascular disease. Another important challenge is widespread availability of automated external defibrillators and effective utilization of public access defibrillation programs for timely and appropriate management of out‐of‐hospital victims with cardiac arrest. This review discusses the current understanding on SCD, risk stratification, and management aimed at reducing SCD, particularly with the use of ICDs. Copyright © 2007 John Wiley & Sons, Ltd.

Keywords: coronary artery disease, congestive heart failure, implantable cardioverter defibrillators, left ventricular ejection fraction, sudden cardiac death

Full Text

The Full Text of this article is available as a PDF (244.9 KB).

REFERENCES

  • 1. Zipes DP, Wellens HJ: Sudden cardiac death. Circulation 1998;98:2334–2351 [DOI] [PubMed] [Google Scholar]
  • 2. Priori SG, Aliot E, Blomstrom‐Lundqvist C, Bossaert L, Breithardt G, et al.: Task force on sudden cardiac death of the European Society of Cardiology. Eur Heart J 2001;22:1374–1450 [DOI] [PubMed] [Google Scholar]
  • 3. Zheng ZJ, Croft JB, Giles WH, Mensah GA: Sudden cardiac death in the United States, 1989 to 1998. Circulation 2001;104:2158–2163 [DOI] [PubMed] [Google Scholar]
  • 4. American Heart Association website. Sudden deaths from cardiac arrest statistics. Available at: https://www.americanheart.org. Accessed July 21, 2005.
  • 5. Spooner PM, Albert C, Benjamin EJ, Boineau R, Elston RC, et al.: Sudden cardiac death, genes and arrhythmogenesis: Consideration of new population and mechanistic approaches from a National Heart, Lung and Blood Institute workshop, part I. Circulation 2001;103:2361–2364 [DOI] [PubMed] [Google Scholar]
  • 6. Myerburg RJ, Castellanos A: Cardiac arrest and sudden cardiac death In Heart Disease: A Textbook of Cardiovascular Medicine 7th ed (Eds. Zipes DP, Libby P, Bonow RO, Braunwald E) pp.865–908. Philadelphia: WB Saunders, 2005. [Google Scholar]
  • 7. Padeletti L, Giaccardi M, Turreni F, Musilli N, Colella A, et al.: Influence of QRS prolongation on the natural history of CHF. Eur Heart J 2004;6(suppl D):D79–D82 [Google Scholar]
  • 8. Jouven X, Empana JP, Schwartz PJ, Desnos M, Courbon D, et al.: Heart rate profile during exercise as a predictor of sudden death. N Engl J Med 2005;352:1951–1958 [DOI] [PubMed] [Google Scholar]
  • 9. Armoundas AA, Hohnloser SH, Ikeda T, Cohen RJ: Can microvolt T‐wave alternans testing reduce unnecessary defibrillator implantation? Nat Clin Pract Cardiovasc Med 2005;2:522–528 [DOI] [PubMed] [Google Scholar]
  • 10. Morgan JM: Patients with ventricular arrhythmias: Who should be referred to an electrophysiologist? Heart 2002;88:544–550 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 11. Echt DS, Liebson PR, Mitchell LB, Peters RW, Obias‐Manno D, et al.: for the Cardiac Arrhythmia Suppression Trial Investigators : Mortality and morbidity in patients receiving encainide, flecainide, or placebo: The Cardiac Arrhythmia Suppression Trial. N Engl J Med 1991;324:781–788 [DOI] [PubMed] [Google Scholar]
  • 12. Beta‐Blocker Heart Attack Trial Research Group : A randomized trial of propranolol in patients with acute myocardial infarction, I: Mortality results. J Am Med Assoc 1982;247:1707–1714 [DOI] [PubMed] [Google Scholar]
  • 13. Brodine WN, Tung RT, Lee JK, Hockstad ES, Moss AJ, et al.: for the MADIT‐II Research Group : Effects of beta‐blockers on implantable cardioverter defibrillator therapy and survival in the patients with ischemic cardiomyopathy (from the Multicenter Automatic Defibrillator Implantation Trial‐II). Am J Cardiol 2005;96:691–695 [DOI] [PubMed] [Google Scholar]
  • 14. Boutitie F, Boissel JP, Connolly SJ, Camm AJ, Cairns JA, ?et al.: for the EMIAT and CAMIAT Investigators : Amiodarone interaction with beta‐blockers: Analysis of the merged EMIAT (European Myocardial Infarct Amiodarone Trial) and CAMIAT (Canadian Amiodarone Myocardial Infarction Trial) databases. Circulation 1999;99:2268–2275 [DOI] [PubMed] [Google Scholar]
  • 15. Domanski MJ, Exner DV, Borkowf CB, Geller NL, Rosenberg Y, et al.: Effect of angiotensin converting enzyme inhibition on sudden death in patients following acute myocardial infarction: A meta‐analysis of randomized clinical trials. J Am Coll Cardiol 1999;33:598–604 [DOI] [PubMed] [Google Scholar]
  • 16. Lindholm LH, Dahlof B, Edelman JM, Ibsen H, Borch‐Johnsen K, et al.: and the LIFE study group : Effect of losartan on sudden cardiac death in people with diabetes: Data from the LIFE study. Lancet 2003;362:619–620 [DOI] [PubMed] [Google Scholar]
  • 17. Pitt B, Gheorghiade M, Zannad F, Anderson JL, van Veldhuisen DJ, et al.: On behalf of the EPHESUS Investigators : Evaluation of eplerenone in the subgroup of EPHESUS patients with baseline left ventricular ejection fraction ≤30%. Eur J Heart Fail 2006;8:295–301 [DOI] [PubMed] [Google Scholar]
  • 18. Makikallio TH, Barthel P, Schneider R, Bauer A, Tapanainen JM, et al.: Frequency of sudden cardiac death among acute myocardial infarction survivors with optimized medical and revascularization therapy. Am J Cardiol 2006;97:480–484 [DOI] [PubMed] [Google Scholar]
  • 19. The Antiarrhythmics Versus Implantable Defibrillators (AVID) Investigators : A comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from near‐fatal ventricular arrhythmias. N Engl J Med 1997;337:1576–1584 [DOI] [PubMed] [Google Scholar]
  • 20. Connolly SJ, Gent M, Roberts RS, Dorian P, Roy D, et al.: Canadian Implantable Defibrillator Study (CIDS) : A randomized trial of the implantable cardioverter defibrillator against amiodarone. Circulation 2000;101:1297–1302 [DOI] [PubMed] [Google Scholar]
  • 21. Kuck KH, Cappato R, Siebels J, Ruppel R: Randomized comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from cardiac arrest: The Cardiac Arrest Study Hamburg (CASH). Circulation 2000;102:748–754 [DOI] [PubMed] [Google Scholar]
  • 22. Connolly SJ, Hallstrom AP, Cappato R, Schron EB, Kuck KH, et al.: Meta‐analysis of the implantable cardioverter defibrillator secondary prevention trials: AVID, CASH and CIDS studies. Eur Heart J 2000;21:?()– 2078 [DOI] [PubMed] [Google Scholar]
  • 23. Bokhari F, Newman D, Greene M, Korley V, Mangat I, et al.: Long‐term comparison of the implantable cardioverter defibrillator versus amiodarone: Eleven‐year follow‐up of a subset of patients in the Canadian Implantable Defibrillator Study (CIDS). Circulation 2004;110:112–116 [DOI] [PubMed] [Google Scholar]
  • 24. Moss AJ, Hall WJ, Cannom DS, Daubert JP, Higgins SL, et al.: Improved survival with an implantable defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. N Engl J Med 1996;335:1933–1940 [DOI] [PubMed] [Google Scholar]
  • 25. Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EN, et al.: A randomized study of the prevention of sudden death in patients with coronary artery disease. N Engl J Med 1999;341:1882–1890 [Erratum, N Engl J Med 2000;342:1300] [DOI] [PubMed] [Google Scholar]
  • 26. Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, et al.: for the Multicenter Automatic Defibrillator Implantation Trial II Investigators : Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med 2002;346:877–883 [DOI] [PubMed] [Google Scholar]
  • 27. Wilber DJ, Zareba W, Hall WJ, Brown MW, Lin AC, et al.: Time dependence of mortality risk and defibrillator benefit after myocardial infarction. Circulation 2004;109:1082–1084 [DOI] [PubMed] [Google Scholar]
  • 28. Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, et al.: for the Sudden Cardiac Death in Heart Failure Trial (SCD‐HeFT) Investigators : Amiodarone or an implantable cardioverter‐defibrillator for congestive heart failure. N Engl J Med 2005;352:225–237 [DOI] [PubMed] [Google Scholar]
  • 29. Solomon SD, Zelenkofske S, McMurray JJ, Finn PV, Velazquez E, et al.: for the Valsartan in Acute Myocardial Infarction Trial (VALIANT) Investigators, Valsartan in Acute Myocardial Infarction Trial Investigators : Sudden death in patients with myocardial infarction and left ventricular dysfunction, heart failure, or both. N Engl J Med 2005;352:2581–2588 [DOI] [PubMed] [Google Scholar]
  • 30. Hohnloser SH, Kuck KH, Dorian P, Roberts RS, Hampton JR, et al.: for the DINAMIT Investigators : Prophylactic use of an implantable cardioverter‐defibrillator after acute myocardial infarction. N Engl J Med 2004;351:2481–2488 [DOI] [PubMed] [Google Scholar]
  • 13. Centers for Medicare & Medicaid Services Web site. Available at: https://www.cms.hhs.gov. Accessed January 19, 2006.
  • 32. Singh SN, Fletcher RD, Fisher SG, Singh BN, Lewis HD, et al.: Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia. Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure. N Engl J Med 1995;333:77–82 [DOI] [PubMed] [Google Scholar]
  • 33. Doval HC, Nul DR, Grancelli HO, Perrone SV, Bortman GR, et al.: Randomized trial of low dose amiodarone in severe congestive heart failure: Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina (GESICA). Lancet 1994;344:493–498 [DOI] [PubMed] [Google Scholar]
  • 34. Bansch D, Antz M, Boczor S, Volkmer M, Tebbenjohanns J, et al.: Primary prevention of sudden death in idiopathic dilated cardiomyopathy: The Cardiomyopathy Trial. Circulation 2002;105:1453–1458 [DOI] [PubMed] [Google Scholar]
  • 35. Strickberger SA, Hummel JD, Bartlett TG, Frumin HI, Schuger CD, et al.: for the AMIOVIRT Investigators : ?atlAmiodarone versus implantable cardioverter‐defibrillator: Randomized trial in patients with nonischemic dilated cardiomyopathy and asymptomatic nonsustained ventricular tachycardia‐AMIOVIRT. J Am Coll Cardiol 2003;41:1707–1712 [DOI] [PubMed] [Google Scholar]
  • 36. Kadish A, Dyer A, Daubert JP, Quigg R, Estes NA, et al.: for the Defibrillators in Non‐Ischemic Cardiomyopathy Treatment Evaluation Investigators : Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. N Engl J Med 2004;350:2151–2158 [DOI] [PubMed] [Google Scholar]
  • 37. Bristow MR, Saxon LA, Boehmer J, Krueger S, Kass DA, et al.: for the Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) Investigators : Cardiac resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med 2004;350:2140–2150 [DOI] [PubMed] [Google Scholar]
  • 38. American Heart Association and International Liaison Committee on Resuscitation : Guidelines 2000 for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2000;102(suppl 1):160–176 [PubMed] [Google Scholar]
  • 39. Hallstrom A, Ornato JP, for The Public Access Defibrillation Trial Investigators : Public‐access defibrillation and survival after out‐of‐hospital cardiac arrest. N Engl J Med 2004;351:637–646 [DOI] [PubMed] [Google Scholar]
  • 40. Davies CS, Colquhoun MC, Boyle R, Chamberlain DA: A national programme for on‐site defibrillation by lay people in selected high‐risk areas. Heart 2005;91:1299–1302 [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 41. Stiell IG, Wells GA, Field B, Spaite DW, Nesbitt LP, et al.: for the Ontario Prehospital Advanced Life Support Study Group : Advanced cardiac life support in out‐of‐hospital cardiac arrest. N Engl J Med 2004;351:647–656 [DOI] [PubMed] [Google Scholar]
  • 42. Bigger JT Jr, for the Coronary Artery Bypass Graft (CABG) Patch Trial Investigators : Prophylactic use of implanted cardiac defibrillators in patients at high risk for ventricular arrhythmias after coronary artery bypass graft surgery. N Engl J Med 1997;337:1569–1575 [DOI] [PubMed] [Google Scholar]

Articles from Clinical Cardiology are provided here courtesy of Wiley

RESOURCES