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Wagner, G. and Glechner, A. (2018): Subcutaneous implantable cardioverter defibrillator (ICD). Decision Support Document 109.

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Cardiovascular disease is a major public health issue accounting for almost 17 million deaths per year globally. According to estimates, 40-50% of them are sudden cardiac deaths. Approximately six million sudden cardiac deaths are caused by ventricular tachyarrhythmias [1]. Several underlying acquired or congenital cardiac conditions are associated with an increased risk of ventricular arrhythmias.

The implantable cardioverter-defibrillator (ICD) device detects and terminates these life-threatening ventricular tachyarrhythmias. Based on evidence from several trials, clinical practice guidelines of cardiological societies recommend the ICD in patients at high risk of developing ventricular tachyar-rhythmia (primary prevention), or in patients who have experienced a prior episode of life-threatening ventricular tachyarrhythmias (secondary prevention).

Results from seven observational studies and one systematic review are insufficient to make conclusions about the comparative effectiveness of subcutaneous and transvenous ICDs. These studies, however, indicate a substantially lower risk for lead complications in patients treated with subcutaneous ICD.

Item Type:Decision Support Document
Keywords:Sudden cardiac death, ventricular tachyarrhythmia, implantable cardioverter-defibrillator (ICD), subcutaneous ICD, transvenous single- or dual-chamber ICD
Subjects:WB Practice of medicine > WB 300-962 Therapeutics
WO Surgery > WO 500-517 Operative surgical procedures. Techniques
W Health professions > W 100-275 Medical, dental and pharmaceutical service plans
WG Cardiovascular system
WO Surgery > WO 505 Minimally invasive surgical procedures
Series Name:Decision Support Document 109
Deposited on:20 Jul 2018 09:50
Last Modified:15 Jul 2020 17:58

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