Implantable cardioverter defibrillator principles

Rajesh Chelliah and Raj Khiani

in Oxford Specialist Handbook of Pacemakers and ICDs 2e

Second edition

Published on behalf of Oxford University Press

Published in print May 2018 | ISBN: 9780199687831
Published online April 2018 | e-ISBN: 9780191767371 | DOI:

Series: Oxford Specialist Handbooks in Cardiology

Implantable cardioverter defibrillator principles

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  • Cardiovascular Medicine
  • Cardiothoracic Surgery


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This chapter covers the principles of implantable cardioverter defibrillators (ICDs). Indications and potential problems for insertion of an ICD are described, including the evidence base for insertion based on randomized trials. International clinical guidelines are summarized. The mechanism and components of an ICD are defined, including diagrams to show the pulse generator, electrodes, and a section on which lead to choose. Arrhythmia detection, sensitivity, oversensing, and rate determination are all discussed. Supraventricular tachycardia (SVT) discriminators, pacing for anti-tachycardia and bradycardia, anti-tachycardia pacing (ATP) delivery, defibrillation, and configuration of shock vector are covered. The importance of avoiding inappropriate shocks is briefly outlined, and strategies for home monitoring are featured.

Chapter.  7081 words.  Illustrated.

Subjects: Cardiovascular Medicine ; Cardiothoracic Surgery

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