Current Device Therapies for Sudden Cardiac Death Prevention - the ICD, Subcutaneous ICD and Wearable ICD. 2019

David Chieng, and Vince Paul, and Russell Denman
Department of Cardiology, Fiona Stanley Hospital, Perth, WA, Australia; Department of Cardiology, Royal Perth Hospital, Perth, WA, Australia. Electronic address: david.chieng@health.wa.gov.au.

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.

UI MeSH Term Description Entries
D004554 Electric Countershock An electrical current applied to the HEART to terminate a CARDIAC ARRHYTHMIA. Cardiac Electroversion,Cardioversion,Defibrillation, Electric,Electroversion, Cardiac,Electrical Cardioversion,Electroversion Therapy,Therapy, Electroversion,Cardiac Electroversions,Cardioversion, Electrical,Cardioversions,Cardioversions, Electrical,Countershock, Electric,Countershocks, Electric,Defibrillations, Electric,Electric Countershocks,Electric Defibrillation,Electric Defibrillations,Electrical Cardioversions,Electroversion Therapies,Electroversions, Cardiac,Therapies, Electroversion
D004867 Equipment Design Methods and patterns of fabricating machines and related hardware. Design, Equipment,Device Design,Medical Device Design,Design, Medical Device,Designs, Medical Device,Device Design, Medical,Device Designs, Medical,Medical Device Designs,Design, Device,Designs, Device,Designs, Equipment,Device Designs,Equipment Designs
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000076251 Wearable Electronic Devices Electronic implements worn on the body as an implant or as an accessory. Examples include wearable diagnostic devices, wearable ACTIVITY TRACKERS, wearable INFUSION PUMPS, wearable computing devices, SENSORY AIDS, and electronic pest repellents. Wearable Computer,Electronic Skin,Wearable Devices,Wearable Technology,Computer, Wearable,Device, Wearable,Device, Wearable Electronic,Electronic Device, Wearable,Skin, Electronic,Technology, Wearable,Wearable Computers,Wearable Device,Wearable Electronic Device,Wearable Technologies
D016757 Death, Sudden, Cardiac Unexpected rapid natural death due to cardiovascular collapse within one hour of initial symptoms. It is usually caused by the worsening of existing heart diseases. The sudden onset of symptoms, such as CHEST PAIN and CARDIAC ARRHYTHMIAS, particularly VENTRICULAR TACHYCARDIA, can lead to the loss of consciousness and cardiac arrest followed by biological death. (from Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 7th ed., 2005) Cardiac Sudden Death,Sudden Cardiac Death,Cardiac Arrest, Sudden,Sudden Cardiac Arrest,Arrest, Sudden Cardiac,Cardiac Arrests, Sudden,Cardiac Death, Sudden,Death, Cardiac Sudden,Death, Sudden Cardiac,Sudden Death, Cardiac
D017147 Defibrillators, Implantable Implantable devices which continuously monitor the electrical activity of the heart and automatically detect and terminate ventricular tachycardia (TACHYCARDIA, VENTRICULAR) and VENTRICULAR FIBRILLATION. They consist of an impulse generator, batteries, and electrodes. Cardioverter-Defibrillators, Implantable,Implantable Cardioverter Defibrillator,Implantable Cardioverter-Defibrillators,Implantable Defibrillators,Cardioverter Defibrillator, Implantable,Cardioverter Defibrillators, Implantable,Cardioverter-Defibrillator, Implantable,Defibrillator, Implantable,Defibrillator, Implantable Cardioverter,Defibrillators, Implantable Cardioverter,Implantable Cardioverter Defibrillators,Implantable Cardioverter-Defibrillator,Implantable Defibrillator

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