Strategies to Reduce Recurrent Shocks Due to Ventricular Arrhythmias in Patients with an Implanted Cardioverter-Defibrillator

Steven H Back, Peter R Kowey, Steven H Back, Peter R Kowey

Abstract

Ventricular arrhythmias are a therapeutic challenge, owing to their relatively unpredictable and deadly nature. Many patients are treated with an implantable cardioverter-defibrillator for either primary or secondary prevention of ventricular arrhythmias, meaning those who are at high risk of versus those who have experienced ventricular arrhythmias or sudden cardiac arrest, respectively. Despite the life-saving benefit, ICD comes with the risk of recurrent shocks for both appropriate and inappropriate rhythms. Patients with recurrent shocks have a poor quality of life and increased mortality rates. In this article, we review data for optimal device settings, medical management and radiofrequency ablation strategies to minimise the frequency of ICD shock, with a focus on treatment of ventricular arrhythmias, to reduce patient morbidity and mortality, and to maximise wellbeing and quality of life.

Keywords: Ventricular arrhythmia; ablation; amiodarone; antiarrhythmic; implanted cardioverter-defibrillator; sotalol.

Conflict of interest statement

Disclosure: SHB has no conflicts of interest to declare. PRK has provided ad hoc consultation to Sanofi, Allergan and Gilead.

Figures

Figure 1:. Suggested Algorithm to Treat Patients…
Figure 1:. Suggested Algorithm to Treat Patients with ICD Therapy

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Source: PubMed

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