Preventing Implantable Cardioverter Defibrillator Shocks Improves Survival

摘要

Implanted cardioverter defibrillators (ICDs) reduce sudden cardiac death and all-cause mortality in patients at an elevated risk of ventricular arrhythmia (VA). Patients with ICDs who receive shocks for VA have an increased mortality primarily due to worsening heart failure. Although VA and ICD shocks are a marker of progression of the underlying cardiomyopathy and disease process, there is evidence suggesting that ICD shocks are directly harmful to the myocardium and may contribute to the increase in mortality. Thus, although ICD shocks are a lifesaving therapy, they are also harmful and should be avoided whenever possible.