Current Indications for the Implantable Cardioverter Defibrillator

Author: Dirk Bocker, MD, Lars Eckardt, MD, Gunter Breithardt, MD, FESC, FACC - University Hospital, Department of Cardiology and Angiology, Munster, Germany Editor: A. John Camm

Introduction. 4. Evolution of guidelines for defibrillator therapy. 5. Format of guidelines. 6. Background of ICD therapy. 7. Aims of ICD therapy. 7. Clinical efficacy of ICD therapy. 8. Alternatives to ICD therapy. 8. Comparison of drugs and devices. 10. Current indications for ICD therapy. 11. Contraindications to ICD therapy. 11. ICD therapy in specific disease states. 12. CAD. 12. Risk stratification. 13. Secondary prevention of cardiac arrest or sustained ventricular tachycardias in patients with coronary artery disease. 17. Primary prevention of sudden cardiac death after myocardial infarction. 23. DCM... 26. Secondary prevention of cardiac arrest or sustained ventricular tachycardias in nonischemic dilated cardiomyopathy. 26. Primary prevention of sudden cardiac death. 27. Brugada syndrome. 33. Secondary prevention of cardiac arrest in patients with Brugada syndrome. 34. Primary prevention of sudden death in patients with the Brugada ECG pattern. 35. Hypertrophic cardiomyopathy. 37. Secondary prevention of cardiac arrest or sustained ventricular tachycardias. 38. Primary prevention of sudden death in HCM... 39. Long QT syndrome. 43. Results of ICD therapy in patients with the long QT syndrome. 46. Short QT Syndrome. 47. Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) 48. Catecholamine- or exercise induced polymorphic ventricular tachycardia. 51. Other patients believed at high risk. 52. Defibrillators as a bridge to heart transplantation. 52. Cardiac Resynchronization Therapy (CRT) 53. Legal implications of defibrillator guidelines. 56. Literature. 64