Defibrillator technology for sudden cardiac death (SCD) prevention now includes the
transvenous implantable cardiac defibrillator (ICD), subcutaneous ICD (S-ICD) and
wearable cardioverter defibrillator (WCD). ICD use improves survival in patients who
survived previous sudden cardiac arrest (SCA) due to ventricular tachycardia (VT)/ventricular
fibrillation (VF), as well as in patients who experienced haemodynamically significant
VT. It is also currently indicated for primary prevention in ischaemic/non-ischaemic
cardiomyopathies, certain congenital heart disease conditions and inherited channelopathies.
In this review article, we hope to present an updated review on ICD use for SCD prevention,
with a focus on contemporary issues affecting ICD selection. These include: the role
of primary prevention ICD in patients with non-ischaemic cardiomyopathy (NICM) in
light of the 2016 DANISH (Danish Study to Assess the Efficacy of ICDs in Patients
with Non-Ischemic Systolic Heart Failure on Mortality) trial; the role of defibrillator
component (CRT-D) in patients receiving cardiac resynchronisation therapy (CRT-P);
and the emerging role of cardiac magnetic resonance imaging (cMRI) in particular,
the presence of late gadolinium enhancement (LGE), as an important SCD risk predictor.
The current use of S-ICD and WCD, including clinical indications, evidence for efficacy
and limitations, will also be discussed.
Keywords
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Article info
Publication history
Published online: October 10, 2018
Identification
Copyright
© 2018 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.
