Biomaterial Database

[The implantable cardiac defibrillator: indications and complications]. 2013

T A Tim Simmers, and Frank A L E Bracke

Catharina Ziekenhuis, afd. Cardiologie, Eindhoven.

The implantation of an implantable cardiac defibrillator (ICD) is indicated as a secondary prevention measure for sudden cardiac death in patients surviving a life-threatening ventricular arrhythmia that had no reversible or treatable cause. An ICD is indicated as a primary prevention measure for sudden cardiac death in patients with a left-ventricular ejection fraction (LVEF) ≤ 35%. A biventricular ICD is indicated in patients with heart failure class ≥ II according to the New York Heart Association classification, a widened QRS complex and an LVEF ≤ 35%. Guidelines do not differentiate between men and women or according to age, but there is no evidence in the literature for decreased mortality from applying ICD therapy in women and in patients older than 70-75 years. This is relevant in discussions over the cost-effectiveness of the treatment. Sudden cardiac death occurs most frequently in patients with an LVEF ≥ 35%; the effect of ICDs as a primary prevention measure in this patient group has, however, never been investigated. The most important complications following ICD implantation are inappropriate ICD shocks and lead dysfunction. Automated home-monitoring enables early detection of technical defects.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D011322	Primary Prevention	Specific practices for the prevention of disease or mental disorders in susceptible individuals or populations. These include HEALTH PROMOTION, including mental health; protective procedures, such as COMMUNICABLE DISEASE CONTROL; and monitoring and regulation of ENVIRONMENTAL POLLUTANTS. Primary prevention is to be distinguished from SECONDARY PREVENTION and TERTIARY PREVENTION.	Prevention, Primary,Disease Prevention, Primary,Prevention, Primordial,Primordial Prevention,Disease Preventions, Primary,Preventions, Primordial,Primary Disease Prevention,Primary Disease Preventions,Primordial Preventions
D003362	Cost-Benefit Analysis	A method of comparing the cost of a program with its expected benefits in dollars (or other currency). The benefit-to-cost ratio is a measure of total return expected per unit of money spent. This analysis generally excludes consideration of factors that are not measured ultimately in economic terms. In contrast a cost effectiveness in general compares cost with qualitative outcomes.	Cost and Benefit,Cost-Benefit Data,Benefits and Costs,Cost Benefit,Cost Benefit Analysis,Cost-Utility Analysis,Costs and Benefits,Economic Evaluation,Marginal Analysis,Analyses, Cost Benefit,Analysis, Cost Benefit,Analysis, Cost-Benefit,Analysis, Cost-Utility,Analysis, Marginal,Benefit and Cost,Cost Benefit Analyses,Cost Benefit Data,Cost Utility Analysis,Cost-Benefit Analyses,Cost-Utility Analyses,Data, Cost-Benefit,Economic Evaluations,Evaluation, Economic,Marginal Analyses
D005260	Female		Females
D006329	Heart Conduction System	An impulse-conducting system composed of modified cardiac muscle, having the power of spontaneous rhythmicity and conduction more highly developed than the rest of the heart.	Conduction System, Heart,Conduction Systems, Heart,Heart Conduction Systems,System, Heart Conduction,Systems, Heart Conduction
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000075224	Cardiac Conduction System Disease	Diseases characterized by pathological irregularities in the HEART CONDUCTION SYSTEM. They may be associated with other heart diseases and syndromes (e.g., BRUGADA SYNDROME; NEUROMUSCULAR DISEASE, HEART BLOCKS), isolated or may result from injuries. You can have a conduction disorder without having an arrhythmia, but some arrhythmias arise from conduction disorders. OMIM: 601144.	Cardiac Conduction Defect,Cardiac Conduction Defects,Cardiac Conduction System Diseases,Conduction Defect, Cardiac,Defect, Cardiac Conduction
D000367	Age Factors	Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.	Age Reporting,Age Factor,Factor, Age,Factors, Age
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly