Feature Article

Implantable defibrillators: preventing sudden cardiac death

Gerry Kaye



Implantable cardioverter defibrillators (ICDs) are recommended for patients at risk of sudden cardiac death caused by cardiac arrhythmias such as ventricular fibrillation and tachycardia. Some ICDs also have ventricular pacing functions that can improve symptoms in patients with poor left ventricular systolic function.

Key Points

  • Implantable cardioverter defibrillators (ICDs) are very successful at reducing sudden death in high-risk patients; all ICDs also have a pacemaker function.
  • Patients with structural heart disease or poor left ventricular systolic function and syncope require urgent cardiological assessment.
  • Patients with poor left ventricular function should be referred for prophylactic ICD assessment.
  • Patients with an ICD require regular cardiological review.
  • Patients with impaired left ventricular systolic function, symptomatic heart failure on optimal medical treatment and broad QRS complexes (≥120 ms) and left bundle branch block should be considered for cardiac resynchronisation therapy.

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