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Europace 2005 7(4):317-318; doi:10.1016/j.eupc.2005.02.121
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© 2005 The European Society of Cardiology. Published by Elsevier Ltd. All rights reserved.

OPINION

Have all the ICD primary prevention trials excluded an important group of patients?

Islam Bolad and David T. Martin*

The Cardiac Arrhythmia Service, Lahey Medical Center Burlington, Massachusetts, USA

Abstract

Primary prevention trials of implantable cardioverter defibrillator (ICD) therapy have generally excluded patients early after revascularization. Clinicians are commonly faced with patients who have ventricular dysfunction and nonsustained ventricular tachyarrhythmia developing shortly after revascularization. Since there are no evidence-based guidelines, management is currently at the discretion of the treating clinician. Recently, evidence has emerged that this patient population is at increased risk of development of life-threatening ventricular tachyarrhythmia and, pending prospective trials, we suggest that ICD therapy should be used in appropriately selected patients with perioperative ventricular arrhythmia.

Key Words: implantable cardioverter defibrillator, cardiac surgery, ventricular tachyarrhythmia

*Corresponding author. Department of Cardiology, 41 Mall Road, Burlington, MA 01805, USA. Tel.: +1 781 744 8863. E-mail address: david.t.martin{at}lahey.org


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