Implantable Cardioverter-Defibrillator (ICD) is ...
ICD is extremely effective in terminating ventricular arrhythmias.
ICD
MAIN INDICATIONS
(click images below for more info or click here to
)
Post arrest
ICM
DCM
HCM
Brugada
Survivor of SCA
from non-reversible causes
Ischemic Cardiomyopathy
LVEF ≤35%, NYHAII+
Dilated Cardiomyopathy
LVEF ≤35%, NYHAII+
Hypertrophic Cardiomyopathy
LV wall thickness >30mm, syncope, NSVT, Family Hx, LGE+ on MRI
Brugada Syndrome
Syncope, spontaneous type I ECG
Y
es, ICD is effective.
But it's only beneficial in a small group of SCD populations.
SCD
prevention
Cigarettes |
Medications |
Fish Oil
Smoking increases risk of SCD by 2.4 times.
Risk of SCD is unrelated to the amount and duration of smoking.
The risk is normalized immediately after quitting.
| Drugs | Possible Mechanisms | %SCD reduction |
|---|---|---|
| Beta Blockers | decrease sympathetic tone, stabilize myocardium | 44% in CIBIS-II |
| Aldosterone Antagonist | reduce inflammation | 29% in RALES |
| ACEI/ARB | reduce electrical irritability | 20% in Meta-analysis |
| Statin | stabilize plaques | 40% in AVID |
| Amiodarone | - | similar events with placebo in SCD-HeFT |
Treatment with omega-3 PUFA supplements is reasonable for the secondary prevention
of CHD death, possibly through a reduction in ischemia induced SCD.(IIb-IIa)
Strategy to Prevent SCD
Identify Substrate
LVEF, NYHA
Stabilize Triggers
Smoking cessation, BB, ACEI, Statin, Aldosterone antagonist,
Normalize electrolytes, Reduce ischemia
Intervene SCA
ICD, AED, Increase public awareness of CPR
heartRhythmBox.com