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Adjuvant Antiarrhythmic Therapy in Patients with Implantable Cardioverter Defibrillators

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Abstract

The risk of sudden cardiac death from ventricular fibrillation or ventricular tachycardia in patients with cardiomyopathy related to structural heart disease has been favorably impacted by the wide adaptation of implantable cardioverter defibrillators (ICDs) for both primary and secondary prevention. Unfortunately, after ICD implantation both appropriate and inappropriate ICD therapies are common. ICD shocks in particular can have significant effects on quality of life and disease-related morbidity and mortality. While not indicated for primary prevention of ICD therapies, beta-blockers and antiarrhythmic drugs are a cornerstone for secondary prevention of them. This review will summarize our current understanding of adjuvant antiarrhythmic drug therapy in ICD patients. The review will also discuss the roles of nonantiarrhythmic drug approaches that are used in isolation and in combination with antiarrhythmic drugs to reduce subsequent risk of ICD shocks.

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Acknowledgments

No external funds were used in the preparation of this review. The authors report the following potential conflicts of interest: TJB has received consultancy fees (minor—Biosense Webster, St. Jude Medical, Boston Scientific) and research grants (Gilead Pharmaceuticals, Boston Scientific, Biosense Webster, St. Jude Medical); JLA has no conflict of interest that might be relevant to the contents of this manuscript.

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  1. Intermountain Heart Institute, Intermountain Medical Center, Eccles Outpatient Care Center, 5169 Cottonwood St, Suite 510, Murray, UT, 84107, USA

    T. Jared Bunch & Jeffrey L. Anderson

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Bunch, T.J., Anderson, J.L. Adjuvant Antiarrhythmic Therapy in Patients with Implantable Cardioverter Defibrillators. Am J Cardiovasc Drugs 14, 89–100 (2014). https://doi.org/10.1007/s40256-013-0056-x

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  • DOI: https://doi.org/10.1007/s40256-013-0056-x

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