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UPDATES FROM THE ANNUAL SESSION

2000-2001 Series: Update Sessions from ACP-ASIM's 2000 Annual Session

Margaret Ring Gillock, Editor; David Cramer, MD, Co-Editor; and Paul T. Kefalides, MD, Co-Editor

The Role of the Implantable Cardioverter-Defibrillator for Prevention of Sudden Cardiac Death

Mark E. Josephson, MD; David J. Callans, MD; and Alfred E. Buxton, MD

5 December 2000 | Volume 133 Issue 11 | Pages 901-910

Sudden cardiac death, which accounts for approximately 350 000 deaths each year, is a major health care problem. Antiarrhythmic drugs have not been reliable in preventing sudden cardiac death. Although ß-blockers, angiotensin-converting enzyme inhibitors, and revascularization play a role in prevention of sudden cardiac death, the development and subsequent refinement of the implantable cardioverter-defibrillator has made the most important contribution to its management. Several randomized, controlled trials have demonstrated improved survival in patients resuscitated from cardiac arrest. Two recent trials also suggest a role for primary prevention in selected patients with coronary artery disease, ventricular dysfunction, and nonsustained ventricular tachycardia in whom sustained ventricular tachycardia is induced. Further technological refinements and development of new, more sensitive risk stratifiers with a higher positive predictive value for sudden cardiac death will expand the indications for this life-saving therapy.

Author and Article Information

From Beth Israel Deaconess Medical Center, Boston, Massachusetts; University of Pennsylvania, Philadelphia, Pennsylvania; and Rhode Island Hospital, Providence, Rhode Island.

Requests for Single Reprints: Mark E. Josephson, MD, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215.

Current Author Addresses: Dr. Josephson: Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215.

Dr. Callans: University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104.

Dr. Buxton: Rhode Island Hospital, 2 Dudley Street, Providence, RI 02905.

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