Key result
This review examines the strong association between implantable cardioverter defibrillator shocks and increased mortality to determine if shocks are a marker of disease severity or directly contribute to mortality.
Why the study?
Do ICD shocks directly contribute to increased mortality or merely serve as a marker of more severe cardiovascular disease in ICD recipients?
Do ICD shocks directly contribute to increased mortality or merely serve as a marker of more severe cardiovascular disease in ICD recipients?
This review highlights the strong association between ICD shocks and mortality, exploring whether shocks directly cause harm or simply reflect underlying disease progression.
Shocks linked to higher mortality in ICD patients; leaves open whether marker or causal, warranting targeted trials.
Large-scale implantable cardioverter defibrillator (ICD) trials have unequivocally shown a reduction in mortality in appropriately selected patients with heart failure and depressed left ventricular function. However, there is a strong association between shocks and increased mortality in ICD recipients. It is unclear if shocks are merely a marker of a more severe cardiovascular disease or directly contribute to the increase in mortality. The aim of this review is to examine the relationship between ICD shocks and mortality, and explore possible mechanisms. Data examining the effect of shocks in the absence of spontaneous arrhythmias as well as studies of non-shock therapy and strategies to reduce shocks are analysed to try and disentangle the shocks versus substrate debate.
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Li et al. (2016) conducted a review in Heart failure and depressed left ventricular function with an implantable cardioverter defibrillator. Implantable cardioverter defibrillator (ICD) shocks was evaluated on Mortality. This review examines the strong association between implantable cardioverter defibrillator shocks and increased mortality to determine if shocks are a marker of disease severity or directly contribute to mortality.
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