A call for re-evaluation of the guidelines for prophylactic ICD implantation.

J G L M Luermans,M Mafi Rad,K Vernooy

doi:10.1007/s12471-014-0591-3

Abstract

A call for re-evaluation of the guidelines for prophylactic ICD implantation.

Highlights

The implantable cardioverter-defibrillator (ICD) is the most effective therapy currently available to prevent sudden cardiac death (SCD) in patients with left ventricular dysfunction.[1,2,3,4] The current ACC/AHA/ESC guidelines for prophylactic ICD implantation in patients with left ventricular dysfunction [5] are based on large randomised clinical trials performed in the 1990s and the beginning of this century.[1,2,3,4] these guidelines might be out of date since the treatment of patients with coronary artery disease (CAD) and dilated cardiomyopathy (DCM) has improved considerably in the last decade
[6] The study population consisted of 320 CAD and 178 DCM patients who received an ICD with or without cardiac resynchronisation therapy (CRT) between January 2005 and June 2012 according to the current guidelines
At 1, 2 and 5 years, mortality rates were 2.2 %, 4.2 % and 13.5 %, respectively. These relatively low mortality rates are in agreement with Smith et al who reported a mortality of 7 %, with no differences between CAD and DCM patients, J

Summary

Introduction

The implantable cardioverter-defibrillator (ICD) is the most effective therapy currently available to prevent sudden cardiac death (SCD) in patients with left ventricular dysfunction.[1,2,3,4] The current ACC/AHA/ESC guidelines for prophylactic ICD implantation in patients with left ventricular dysfunction [5] are based on large randomised clinical trials performed in the 1990s and the beginning of this century.[1,2,3,4] these guidelines might be out of date since the treatment of patients with coronary artery disease (CAD) and dilated cardiomyopathy (DCM) has improved considerably in the last decade. In this issue of the Netherlands Heart Journal Verhagen and co-workers report their retrospective follow-up data of ICD implantations in patients with impaired left ventricular function due to CAD or DCM.

Results

Conclusion