Journal of Interventional Cardiac Electrophysiology

, Volume 23, Issue 1, pp 29–39

The future of implantable defibrillator and cardiac resynchronization therapy trials

Article

DOI: 10.1007/s10840-008-9302-6

Cite this article as:
Saksena, S. & Nagarakanti, R. J Interv Card Electrophysiol (2008) 23: 29. doi:10.1007/s10840-008-9302-6

Abstract

Implantable cardioverter defibrillator (ICD) trials were initially limited to survivors of sudden death. The focus of defibrillator trials in the last decade has been in prophylactic implantation of the device in high risk populations for the prevention of sudden cardiac death. It is the contention in this review that the new focus for implantable defibrillator trials in 2008 and beyond will be on more selective and focused use of this therapy. This could be achieved by selecting ICD patients based on their pathophysiologic and genetic risk. Increasing effort will also be placed on using the device for prevention of spontaneous malignant ventricular tachyarrhythmias and the index clinical sudden death event. Finally, implantable defibrillators will be used in combination in a “hybrid” therapy approach. ICDs will be increasingly combined either with ventricular tachycardia ablation or ventricular fibrillation ablation using catheter techniques. With the addition of cardiac resynchronization therapy in these devices, new clinical trials that use cardiac resynchronization therapy as an early intervention in specific high risk heart failure populations and refinement of the CRT technique to improved optimal results are in progress. Finally, combining ICD devices and regenerative medicine approaches to myocardial replacement therapy are being explored.

Keywords

Sudden deathImplantable defibrillatorsHeart failureCardiac resynchronization therapyTherapy for arrhythmiasTherapy for heart failureReviewsMyocardial infarctionClinical trialsGenetics of arrhythmiasCongenital heart diseaseAcquired heart disease

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  1. 1.Electrophysiology Research FoundationWarrenUSA