A 59-Year-Old Man Considering Implantation of a Cardiac Defibrillator

Nearly 450 000 individuals experience sudden cardiac death yearly in the United States. A history of prior myocardial infarction with resultant left ventricular dysfunction identifies a group at particularly high risk of sudden arrhythmic death. Implantable cardioverter-defibrillators have proven hi...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 2007-05, Vol.297 (17), p.1909-1916
Main Author: Zimetbaum, Peter J
Format: Article
Language:English
Subjects:
Arrhythmias, Cardiac - physiopathology
Biological and medical sciences
Case studies
Death, Sudden, Cardiac - prevention & control
Decision Making
Defibrillators
Defibrillators, Implantable - economics
Equipment Failure
General aspects
Heart attacks
Heart failure
Heart Failure - complications
Humans
Male
Medical sciences
Middle Aged
Myocardial Infarction - complications
Practice Guidelines as Topic
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Risk
Risk factors
Transplants & implants
Ventricular Dysfunction, Left
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Description
Summary:Nearly 450 000 individuals experience sudden cardiac death yearly in the United States. A history of prior myocardial infarction with resultant left ventricular dysfunction identifies a group at particularly high risk of sudden arrhythmic death. Implantable cardioverter-defibrillators have proven highly effective at reducing this risk and are now increasingly implanted in patients with this risk profile. The case of Mr M, a 59-year-old man with a history of myocardial infarction, low ejection fraction, and mild congestive heart failure, who is considering implantable cardioverter-defibrillator placement, illustrates the issues in having a device implanted as a prophylactic measure as well as increasing concerns due to device recalls and malfunction. A thorough discussion of the benefits and risks associated with this therapy is necessary for patients and physicians to make appropriate decisions with regard to the primary prevention of sudden death.
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.297.17.1909