Tachyarrhythmia |
ICD Patient Indications
The data from new outcome studies and ongoing clinical experience with ICDs have resulted in broader patient indications from the American College of Cardiology (ACC), the American Heart Association (AHA), the European Society of Cardiology (ESC) and the Canadian Cardiovascular Society (CCS).1-3
A brief comparison of the guidelines published in the United States, Europe, and Canada is shown in the table below.
| Summary of Class I or II ICD Guidelines for the United States (ACC/AHA), Europe (ESC) and Canada (CCS)4 | |||
|---|---|---|---|
| Recommended ICD Therapy for the Following Patients: |
ACC/AHA 1998 |
ESC 2001 |
CCS 2000 |
| Cardiac arrest due to VT/VF, not due to transient/reversible cause | X |
X |
X |
| Cardiac arrest, due to suspected VT, EPS not possible, or successful defibrillation or inducible VT/VF or other relevant clinical data | X |
X |
|
| Spontaneous sustained VT | X |
X (w/ hemodynamic instability, or LVEF < 40% and few symptoms) |
X (w/ syncope, or if LVEF < 35%) |
| Syncope unknown etiology, hemodynamically significant sustained VT/VF induced at EPS, when drug therapy cannot be used | X |
X |
|
| Syncope of unknown etiology, with LV disfunction, and inducible VT/VF at EPS | X |
||
| Symptomatic VT, awaiting cardiac transplant | X |
X |
|
| Familial or inherited conditions (LQTS, HCM, Brugada, ARVD) with high risk of life-threatening ventricular tachyarrhythmia | X |
X |
X |
| Post-MI, NSVT, LV dysfunction, inducible VT | X |
X |
X |
References
- Gregoratos G, Cheitlin M, Conill A, et al. ACC/AHA guidelines for implantation of cardiac pacemakers and antiarrhythmia devices: A report of the ACC/AHA Task Force on Practice Guidelines (Committee on Pacemaker Implantation). J Am Coll Cardiol. 1998;31:1175-1209.
- Priori S, Blomstrom-Lundqvist A, Breithardt B, et al. Task force on sudden cardiac death of the European Society of Cardiology. Eur Heart J. 2001;22:1374-1450.
- Canadian Cardiovascular Society Consensus Conference Statement on the Prevention of Sudden Death from Ventricular Arrhythmias. The Canadian Journal of Cardiology. 2000;16 Suppl C.
- McGrory-Usset M, Stanton M. Use of implantable cardioverter defibrillator (ICD) therapy and ICD guidelines around the world. In New Developments in Cardiac Pacing and Electrophysiology. I.E. Ovsyshcher (Editor) Armonk, NY: Futura Publ. Co., Inc. 2002:81-90.
Additional Information
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