The implantable cardioverter-defibrillator (ICD) is established asan effective therapy for ventricular arrhythmias and is now routinelyused for both primary and secondary prevention of suddencardiac death in at-risk populations. Patients with heart failure(HF) have an increased propensity to arrhythmic sudden deathand large randomized trials have demonstrated a clear mortalitybenefit following ICD implantation in selected HF patients. Despitethis, the optimal use of ICDs in patients with HF remains a particularlychallenging area of clinical practice. This is primarily becausepatients with HF are exposed to competing risks, which are both dynamic and difficult to quantify. As the cost and morbidity associatedwith ICD implantation are not insignificant, careful consideration of the risks and benefits associated with ICD implantationin each individual patient is required.
Chapter. 12708 words. Illustrated.
Subjects: Cardiovascular Medicine
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