Current Indications for Implantable Cardioverter Defibrillators in Non-Ischemic Cardiomyopathies and Channelopathies

Title:Current Indications for Implantable Cardioverter Defibrillators in Non-Ischemic Cardiomyopathies and Channelopathies

Volume: 10 Issue: 2

Author(s): Esteban Gonzalez-Torrecilla, Angel Arenal, Felipe Atienza, Tomas Datino, Loreto Bravo, Pablo Ruiz, Pablo Avila and Francisco Fernandez-Aviles

Affiliation:

Keywords: Guidelines, implantable cardioverter defibrillator, cardiomyopathies, channelopathies, primary prevention, risk score, sudden cardiac death.

Abstract: Current indications for implantable cardioverter defibrillators (ICDs) in patients with channelopathies and cardiomyopathies of non-ischemic origin are mainly based on non-randomized evidence. In patients with nonischemic dilated cardiomyopathy (NIDCM), there is a tendency towards a beneficial effect on total mortality of ICD therapy in patients with significant left ventricular (LV) dysfunction. Although an important reduction in sudden cardiac death (SCD) seems to be clearly demonstrated in these patients, a net beneficial effect on total mortality is unclear mostly in cases with good functional status. Risk stratification has been changing over the last two decades in patients with hypertrophic cardiomyopathy (HCM). Its risk profile has been delineated in parallel with the beneficial effect of ICD in high risk patients. Observational results based on “appropriate” ICD interventions do support its usefulness both in primary and secondary SCD prevention in these patients. Novel risk models quantify the rate of sudden cardiac death in these patients on individual basis. Less clear risk stratification is available for cases of arrhythmogenic right ventricular cardiomyopathy (ARVC) and in other uncommon familiar cardiomyopathies. Main features of risk stratification vary among the different channelopathies (long QT syndrome -LQTS-, Brugada syndrome, etc) with great debate on the management of asymptomatic patients. For most familiar cardiomyopathies, ICD therapy is the only accepted strategy in the prevention of SCD. So far, genetic testing has a limited role in risk evaluation and management of the individual patient. This review aims to summarize these criticisms and to refine the current indications of ICD implantation in patients with cardiomyopathies and major channelopathies.

Cite this article as:

Gonzalez-Torrecilla Esteban, Arenal Angel, Atienza Felipe, Datino Tomas, Bravo Loreto, Ruiz Pablo, Avila Pablo and Fernandez-Aviles Francisco, Current Indications for Implantable Cardioverter Defibrillators in Non-Ischemic Cardiomyopathies and Channelopathies, Reviews on Recent Clinical Trials 2015; 10 (2) . https://dx.doi.org/10.2174/1574887110666150407104312

DOI https://dx.doi.org/10.2174/1574887110666150407104312	Print ISSN 1574-8871
Publisher Name Bentham Science Publisher	Online ISSN 1876-1038