Ventricular tachycardia primary prevention: Difference between revisions
Line 7: | Line 7: | ||
==[[Primary Prevention]]== | ==[[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. | * [[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.<ref name="HohnloserKuck2004">{{cite journal|last1=Hohnloser|first1=Stefan H.|last2=Kuck|first2=Karl Heinz|last3=Dorian|first3=Paul|last4=Roberts|first4=Robin S.|last5=Hampton|first5=John R.|last6=Hatala|first6=Robert|last7=Fain|first7=Eric|last8=Gent|first8=Michael|last9=Connolly|first9=Stuart J.|title=Prophylactic Use of an Implantable Cardioverter–Defibrillator after Acute Myocardial Infarction|journal=New England Journal of Medicine|volume=351|issue=24|year=2004|pages=2481–2488|issn=0028-4793|doi=10.1056/NEJMoa041489}}</ref> | ||
* In [[patients]] with [[LVEF ]] ≤30% and prior [[MI ]] and [[NYHA]] class I symptoms , [[ICD]] implantation was associated with survival benefit. | * 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]]. | * Analysis of [[MADIT]], [[MADIT-II]], and [[SCD-HeFT]] showed survival benefit of [[ICD]] implantation for [[primary prevention]] of [[ventricular arrhythmia]]. |
Revision as of 03:49, 15 May 2021
Ventricular tachycardia Microchapters |
Differentiating Ventricular Tachycardia from other Disorders |
---|
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.[1]
- 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.
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 |
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
References
- ↑ Hohnloser, Stefan H.; Kuck, Karl Heinz; Dorian, Paul; Roberts, Robin S.; Hampton, John R.; Hatala, Robert; Fain, Eric; Gent, Michael; Connolly, Stuart J. (2004). "Prophylactic Use of an Implantable Cardioverter–Defibrillator after Acute Myocardial Infarction". New England Journal of Medicine. 351 (24): 2481–2488. doi:10.1056/NEJMoa041489. ISSN 0028-4793.