Hostname: page-component-6766d58669-bp2c4 Total loading time: 0 Render date: 2026-05-23T06:03:08.275Z Has data issue: false hasContentIssue false
  • English
  • Français

Implantable cardioverter-defibrillator implantation for primary and secondary prevention: indications and outcomes

Published online by Cambridge University Press:  13 January 2017

Justin M. Pick  and
Anjan S. Batra
Justin M. Pick
Affiliation:
Children’s Hospital of Orange County, University of California Irvine, Irvine, California, United States of America
Anjan S. Batra*
Affiliation:
Children’s Hospital of Orange County, University of California Irvine, Irvine, California, United States of America
*
Correspondence to: A. S. Batra, MD, 1140 W. La Veta Avenue, Suite 750; Orange, CA 92868, United States of America. Tel: +714 581 4401; Fax: 714-581-4420; E-mail: abatra@uci.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Implantable cardioverter-defibrillators effectively reduce the rate of sudden cardiac death in children. Significant efforts have been made to better characterise the indications for their placement, and over the past two decades there has been a shift in their use from secondary to primary prevention. Primary prevention includes placement in patients thought to be at high risk of sudden cardiac death before the patient experiences any event. Secondary prevention includes placement after a high-risk event including sustained ventricular tachycardia or resuscitated cardiac arrest. Although liberal device implantation may be appealing even in patients having marginal indications, studies have shown high rates of adverse effects including inappropriate device discharges and the need for re-intervention because of hardware malfunction. The indications for placement of an implantable cardioverter-defibrillator, whether for primary or secondary prevention of sudden cardiac death, vary based on cardiac pathology. This review will assist the provider in understanding the risks and benefits of device implantation in order to enhance the shared decision-making capacity of patients, families, and providers.

Keywords

Implantable cardioverter-defibrillatorprimary preventionsecondary preventionsudden cardiac death

Information

Type
Original Articles
Information
Cardiology in the Young , Volume 27 , Supplement S1: Sudden Cardiac Arrest in the Young: A Contemporary Perspective , January 2017 , pp. S126 - S131
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

1. Maron, BJ, Haas, TS, Ahluwalia, A, Murphy, CJ, Garberich, RF. Demographics and epidemiology of sudden death in young competitive athletes: from the U.S. National Registry. Am J Med 2016; 129: 1170–1177.Google Scholar
2. Olde Nordkamp, LRA, Wilde, AAM, Tijssen, JGP, Knops, RE, van Dessel, PFHM, de Groot, JR. The ICD for primary prevention in patients with inherited cardiac diseases: indications, use, and outcome: a comparison with secondary prevention. Circ Arrhythm Electrophysiol 2013; 6: 91–100.Google Scholar
3. Schwartz, PJ, Spazzolini, C, Priori, SG, et al. Who are the longQT syndrome patients who receive an implantable cardioverter-defibrillator and what happens to them?: data from the European Long-QT Syndrome Implantable Cardioverter-Defibrillator (LQTS ICD) Registry. Circulation 2010; 122: 1272–1282.Google Scholar
4. Maron, BJ, Spirito, P, Ackerman, MJ, et al. Prevention of sudden cardiac death with implantable cardioverter-defibrillators in children and adolescents with hypertrophic cardiomyopathy. J Am Coll Cardiol 2013; 61: 1527–1535.Google Scholar
5. Silka, MJ, Kron, J, Dunnigan, A, Dick, M. Sudden cardiac death and the use of implantable cardioverter-defibrillators in pediatric patients. The pediatric electrophysiology society. Circulation 1993; 87: 800–807.Google Scholar
6. Bardy, GH, Lee, KL, Mark, DB, et al. Amiodarone or an implantable cardioverter–defibrillator for congestive heart failure. N Engl J Med 2005; 352: 225–237.Google Scholar
7. Olde Nordkamp, LRA, Postema, PG, Knops, RE, et al. Implantable cardioverter-defibrillator harm in young patients with inherited arrhythmia syndromes: a systematic review and meta-analysis of inappropriate shocks and complications. Heart Rhythm 2016; 13: 443–454.Google Scholar
8. Bergen Von, NH, Atkins, DL, Dick, M, et al. Multicenter study of the effectiveness of implantable cardioverter defibrillators in children and young adults with heart disease. Pediatr Cardiol 2011; 32: 399–405.Google Scholar
9. Burns, KM, Evans, F, Kaltman, JR. Pediatric ICD utilization in the United States from 1997 to 2006. Heart Rhythm 2011; 8: 23–28.Google Scholar
10. Priori, SG, Wilde, AA, Horie, M, et al. HRS/EHRA/APHRS expert consensus statement on the diagnosis and management of patients with inherited primary arrhythmia syndromes: document endorsed by HRS, EHRA, and APHRS in May 2013 and by ACCF, AHA, PACES, and AEPC in June 2013. Heart Rhythm 2013; 10: 1932–1963.CrossRefGoogle ScholarPubMed
11. Sherrid, MV, Daubert, JP. Risks and challenges of implantable cardioverter-defibrillators in young adults. Prog Cardiovasc Dis 2008; 51: 237–263.Google Scholar
12. Khairy, P, Van Hair, GF, Balaji, S, et al. PACES/HRS expert consensus statement on the recognition and management of arrhythmias in adult congenital heart disease: developed in partnership between the Pediatric and Congenital Electrophysiology Society (PACES) and the Heart Rhythm Society (HRS). Endorsed by the governing bodies of PACES, HRS, the American College of Cardiology (ACC), the American Heart Association (AHA), the European Heart Rhythm Association (EHRA), the Canadian Heart Rhythm Society (CHRS), and the International Society for Adult Congenital Heart Disease (ISACHD). Heart Rhythm 2014; 11: e102–e165.Google Scholar
13. Epstein, AE, DiMarco, J, Ellenbogen, KA, et al. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the ACC/AHA/NASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices) developed in collaboration with the American Association for Thoracic Surgery and Society of Thoracic Surgeons. J Am Coll Cardiol 2008; 51: e1–e61.Google Scholar
14. Elliott, PM, Anastasakis, A, Borger, MA, et al. ESC 2014 guidelines for the diagnosis and management of hypertrophic cardiomyopathy of the Europeanciety of cardiology. Eur Heart J 2014; 35: 2733–2779.Google Scholar
15. Zipes, DP, Camm, AJ, Borggrefe, M, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation 2006; 114: e385–e484.CrossRefGoogle Scholar
16. DeWitt, ES, Triedman, JK, Cecchin, F, et al. Time dependence of risks and benefits in pediatric primary prevention implantable cardioverter-defibrillator therapy. Circ Arrhythm Electrophysiol 2014; 7: 1057–1063.CrossRefGoogle ScholarPubMed
17. Vollmann, D, Lüthje, L, Unterberg, C. Inappropriate therapy and fatal proarrhythmia by an implantable cardioverter defibrillator. Heart Rhythm 2005; 2: S61.Google Scholar
18. Link, MS, Hill, SL, Cliff, DL, et al. Comparison of frequency of complications of implantable cardioverter-defibrillators in children versus adults. Am J Cardiol 1999; 83: 263–266.Google Scholar
19. Friedman, PA, McClelland, RL, Bamlet, WR, et al. Dual-chamber versus single-chamber detection enhancements for implantable defibrillator rhythm diagnosis: the detect supraventricular tachycardia study. Circulation 2006; 113: 2871–2879.CrossRefGoogle ScholarPubMed
20. Theuns, DAMJ, Klootwijk, APJ, Goedhart, DM, Jordaens, LJLM. Prevention of inappropriate therapy in implantable cardioverter-defibrillators: results of a prospective, randomized study of tachyarrhythmia detection algorithms. J Am Coll Cardiol 2004; 44: 2362–2367.CrossRefGoogle ScholarPubMed
21. Uslan, DZ. Permanent pacemaker and implantable cardioverter defibrillator infection. Arch Intern Med 2007; 167: 669–675.Google Scholar
22. Kleemann, T, Becker, T, Doenges, K, et al. Annual rate of transvenous defibrillation lead defects in implantable cardioverter-defibrillators over a period of >10 years. Circulation 2007; 115: 2474–2480.Google Scholar
23. Moss, AJ, Schuger, C, Beck, CA, et al. Reduction in inappropriate therapy and mortality through ICD programming. N Engl J Med 2012; 367: 2275–2283.CrossRefGoogle ScholarPubMed