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ICD-Therapie zur Primärprävention des plötzlichen Herztodes

Risikostratifikation und Patientenselektion

ICD therapy in the primary prevention of sudden cardiac death

Risk stratification and patient selection

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Zusammenfassung

Ohne das Konzept der Primärprävention des plötzlichen Herztods hätte die Therapie mit dem implantierbaren Kardioverter-Defibrillator (ICD) die heutige Verbreitung und klinische Bedeutung nicht erreicht. Die wissenschaftliche Evidenz des Konzeptes geht mehrheitlich auf klinische Studien aus den Jahren 1996 bis 2005 zurück. Aktuell werden mehr als 75 % aller ICD-Implantationen mit der Indikation zur Primärprävention durchgeführt. Die ICD-Therapie zur Primärprävention des plötzlichen Herztods ist in den publizierten Leitlinien seit 1998 abgebildet. Die folgenden Ausführungen sollen die historischen Entwicklungen der Indikationen zur ICD-Primärprävention unter Berücksichtigung wesentlicher Ergebnisse kontrolliert-randomisierter klinischer Studien und Leitliniendiskussionen darstellen.

Abstract

Without the concept of primary prevention of sudden cardiac death, therapy with implantable defibrillators would not have reached the current distribution and clinical importance. Most of the scientific evidence of the concept is based on clinical studies from 1996–2005. More than 75 % of all defibrillator implantations are currently indicated as primary prevention. Implantable converter–defibrillator (ICD) therapy in the primary prevention of sudden cardiac death was incorporated into scientific guidelines starting in 1998. The historical development of the indications for ICD therapy in the primary prevention of sudden cardiac death is presented, reflecting major results of controlled, randomized clinical studies and guideline discussions.

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  1. Medizinischen Klinik II, Klinikum Kassel, Mönchebergstrasse 41–43, 34125, Kassel, Deutschland

    J. Neuzner &  R. Gradaus

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Neuzner, J., Gradaus, R. ICD-Therapie zur Primärprävention des plötzlichen Herztodes. Herzschr Elektrophys 26, 75–81 (2015). https://doi.org/10.1007/s00399-015-0371-9

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  • DOI: https://doi.org/10.1007/s00399-015-0371-9

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