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Primary prevention with the ICD in clinical practice: not as straightforward as the guidelines suggest?

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Abstract

At first sight, guidelines for implantation of an implantable cardioverter defibrillator (ICD) for primary prevention of sudden cardiac death in patients with left ventricular systolic dysfunction seem unambiguous. There are clear cut-off values for ejection fraction, and functional class. However, determination of the ejection fraction itself is not unambiguous, and other risk factors for sudden death that may have a profound effect on risk are not used for decision-making. Furthermore, to obtain a clinically significant impact on survival, expected longevity is important as it can greatly compromise the benefit in elderly patients but underestimate the long-term potential of ICD therapy in younger patients. (Neth Heart J 2009; 17:107–10.)

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    F. A. L. E. Bracke

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  1. F. A. L. E. Bracke
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  2. L. R. C. Dekker
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  3. P. H. van der Voort
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  4. A. Meijer
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Correspondence to F. A. L. E. Bracke.

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Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands

F. Bracke Department of Cardiology, Catharina Hospital, PO Box 1350, 5602 ZA Eindhoven, the Netherlands

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Bracke, F.A.L.E., Dekker, L.R.C., van der Voort, P.H. et al. Primary prevention with the ICD in clinical practice: not as straightforward as the guidelines suggest?. NHJL 17, 107–110 (2009). https://doi.org/10.1007/BF03086228

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