Ventricular tachycardia primary prevention: Difference between revisions
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* Analysis of [MADIT]], [[MADIT-II]], and [[SCD-HeFT]] showed survival benefit of [[ICD]] implantation for [[primary prevention of [[ventricular arrhythmia]]. | * Analysis of [MADIT]], [[MADIT-II]], and [[SCD-HeFT]] showed survival benefit of [[ICD]] implantation for [[primary prevention of [[ventricular arrhythmia]]. | ||
* There was not survival benefit of [[ICD]] implantation in [[patients]] with [[NYHA]] class IV [[heart failure]]. | * There was not survival benefit of [[ICD]] implantation in [[patients]] with [[NYHA]] class IV [[heart failure]]. | ||
<span style="font-size:85%">'''Abbreviations:''' | |||
'''MI:''' [[Myocardial infarction]]; | |||
'''VT:''' [[Ventricular tachycardia]]; | |||
'''VF:''' [[Ventricular fibrillation]]; | |||
'''LVEF:''' [[Left ventricular ejection fraction]]; | |||
'''ICD:''' [[Implantable cardioverter defibrillator]]; | |||
'''NYHA:''' [[New York Heart Association]] functional classification; | |||
'''LVAD:''' [[Left ventricular assist device]]; | |||
'''EPS:''' [[Electrophysiology study]] | |||
</span> | |||
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| style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF;" align=center |'''Recommendations for primary prevention of sudden cardiac death in ischemic heart disease''' | |||
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|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left | '''[[ICD]] implantation ([[ACC AHA guidelines classification scheme|Class I, Level of Evidence A]]):''' | |||
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❑ In patients with [[LVEF]]≤ 35% and [[NYHA]] class 2,3 [[heart failure]] despite medical therapy, at least 40 days post [[MI]] or 90 days post [[revascularization]] with life expectancy > 1 year <br | |||
❑ In patients with [[LVEF]]≤ 30% and [[NYHA]] class 1 [[heart failure]] despite medical therapy at least 40 days post [[MI]] or 90 days [[postrevascularization]] with life expectancy > 1 year | |||
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|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''[[ICD]] implantation ([[ACC AHA guidelines classification scheme|Class I, Level of Evidence B]]) :''' | |||
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|style="padding: 0 5px; font-size: 100%; background: #F5F5F5; width: 70%" align=left| | |||
❑ In patients with [[LVEF]] ≤ 40% and nonsustained [[VT]] due to prior [[MI]] or [[VT]] ,[[VF]] inducible in [[EPS]] with life expectancy >1 year<br> | |||
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|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''[[ICD implantation]] : ([[ACC AHA guidelines classification scheme|Class IIa, Level of Evidence B]])''' | |||
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❑ In patients with [[NYHA]] class 4 who are candidates for cardiac transplantation or [[LVAD]] with life expectancy > 1 year | |||
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|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''([[ACC AHA guidelines classification scheme|Class III, Level of Evidence C]])''' | |||
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|style="padding: 0 5px; font-size: 100%; background: #F5F5F5; width: 70%" align=left| | |||
❑ [[ICD ]] is not beneficial in patients with [[NYHA]] class 4 despite optimal medical therapy who are not candidates for [[cardiac transplantation]] or [[LVAD]] | |||
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==References== | ==References== |
Revision as of 03:15, 14 May 2021
Ventricular tachycardia Microchapters |
Differentiating Ventricular Tachycardia from other Disorders |
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Diagnosis |
Treatment |
Case Studies |
Ventricular tachycardia primary prevention On the Web |
to Hospitals Treating Ventricular tachycardia primary prevention |
Risk calculators and risk factors for Ventricular tachycardia primary prevention |
Overview
Implantable cardioverter-defibrillator (ICD) can be used for patients with idiopathic dilated cardiomyopathy (DCM) for primary or secondary prevention of ventricular arryhthmias.
Primary Prevention
- Primary prevention strategy for heart failure patients with NYHA class II or III, and LVEF ≤35% at least 40 days after myocardial infarction is ICD implantation.
- In patients with LVEF ≤30% and prior MI and NYHA class I symptoms , ICD implantation was associated with survival benefit.
- Analysis of [MADIT]], MADIT-II, and SCD-HeFT showed survival benefit of ICD implantation for [[primary prevention of ventricular arrhythmia.
- There was not survival benefit of ICD implantation in patients with NYHA class IV heart failure.
Abbreviations:
MI: Myocardial infarction;
VT: Ventricular tachycardia;
VF: Ventricular fibrillation;
LVEF: Left ventricular ejection fraction;
ICD: Implantable cardioverter defibrillator;
NYHA: New York Heart Association functional classification;
LVAD: Left ventricular assist device;
EPS: Electrophysiology study
Recommendations for primary prevention of sudden cardiac death in ischemic heart disease |
ICD implantation (Class I, Level of Evidence A): |
❑ In patients with LVEF≤ 35% and NYHA class 2,3 heart failure despite medical therapy, at least 40 days post MI or 90 days post revascularization with life expectancy > 1 year |
ICD implantation (Class I, Level of Evidence B) : |
❑ In patients with LVEF ≤ 40% and nonsustained VT due to prior MI or VT ,VF inducible in EPS with life expectancy >1 year |
ICD implantation : (Class IIa, Level of Evidence B) |
❑ In patients with NYHA class 4 who are candidates for cardiac transplantation or LVAD with life expectancy > 1 year |
(Class III, Level of Evidence C) |
❑ ICD is not beneficial in patients with NYHA class 4 despite optimal medical therapy who are not candidates for cardiac transplantation or LVAD |