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Reviews in Cardiovascular Medicine (RCM) is published by IMR Press from Volume 19 Issue 1 (2018). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with MedReviews, LLC.
Open Access
Review
Primary and Secondary Prevention of Sudden Cardiac Death: The Role of the Implantable Cardioverter Defibrillator
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1
Indiana Heart Institute, St. Vincent Hospital, Indianapolis, IN
Rev. Cardiovasc. Med. 2001, 2(4), 197–205;
Published: 30 December 2001
Abstract
Sudden cardiac death (SCD) affects nearly 300,000 people each year in the U.S., and
out-of-hospital rates for survival range from only 2% to 25%. A substantial reduction
in SCD requires primary prevention through risk-stratification and secondary prevention
of sustained ventricular tachycardia (VT-S) and ventricular fibrillation (VF). Because
frequent premature ventricular complexes (PVCs) appeared to be associated with an
increased risk for SCD in patients with significant ventricular dysfunction, it was thought
that suppression of PVCs would prevent SCD. The implantable cardioverter defibrillator
(ICD) electrically treats life-threatening VT-S and VF, and it can be implanted readily
in the pectoral area. Two randomized, prospective, controlled trials demonstrated
conclusively that the ICD is the treatment of choice in the primary prevention of SCD
in patients with a previous MI. In addition, three randomized, controlled trials found
the ICD to be superior to antiarrhythmic drugs in the secondary prevention of SCD.
Physicians should learn to recognize patients who are candidates for the ICD and
refer them to an electrophysiologist so that they can get this life-saving therapy
Keywords
Sudden cardiac death
Ventricular fibrillation
Sustained ventricular tachycardia
Premature ventricular complexes
Antiarrhythmic drugs
Implantable cardioverter defibrillator