Key result
ICDs require updated indications for SCD prevention because older trials ignore modern HF treatments.
Why the study?
Major randomized trials on ICD effectiveness were conducted 20 years ago, while modern ICDs and heart failure treatments have drastically improved, requiring updated approaches to SCD risk and ICD indications.
The review highlights the need to update sudden cardiac death risk assessment and ICD indications, as foundational trials do not reflect modern heart failure therapies and device advancements.
ICD indications should not yet change without new data; leaves open optimal SCD risk stratification in modern HF.
Implantable cardioverter-defibrillators (ICDs) are considered to be the most beneficial in preventing sudden cardiac death (SCD), especially in patients with reduced left ventricular ejection fraction (LVEF). However, major large-scale randomized clinical trials on ICD effectiveness were conducted 20 years ago and do not reflect current realities. Modern ICDs and methods for treating heart failure have drastically improved. New clinical reality requires reconsideration of approaches to determining the risk of SCD and indications for ICD, personalization of device selection and programming, and identification of barriers that prevent ubiquitous use of the method in real clinical practice. The article reviews the available evidence base on the use of ICDs, current clinical guidelines, complications following the device implantation, and any difficulties associated with ICD application in routine clinical practice.
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Talibullin et al. (2022) conducted a review in Sudden cardiac death. Implantable cardioverter-defibrillators (ICDs) was evaluated. Implantable cardioverter-defibrillators require updated indications for sudden cardiac death prevention, as major trials from 20 years ago do not reflect modern heart failure treatments.
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