Implantable Defibrillator Therapy: A Clinical Guide

1. Front Matter

   Pages i-x

   PDF

2. Indication for ICD Therapy

   • Dirk Böcker, Martin Borggrefe

   Pages 1-14

3. Overview of Instrumentation

   • Philip D. Henry, Mike Hardage

   Pages 15-41

4. Defibrillator Leads

   • Philip D. Henry, Antonio Pacifico

   Pages 43-62

5. Atrial Defibrillators

   • Philip D. Henry, Antonio Pacifico

   Pages 63-76

6. Implantation

   • Antonio Pacifico, Philip D. Henry

   Pages 77-112

7. Device Testing and Programming at Implantation

   • Adam H. Zivin, Gust H. Bardy

   Pages 113-137

8. Testing at Discharge

   • Adam Zivin, Gust H. Bardy

   Pages 139-145

9. Postoperative Follow-Up and Complications

   • Antonio Pacifico, Philip D. Henry

   Pages 147-159

10. Long-Term Follow-Up

    • Andrea M. Russo, Francis E. Marchlinski

    Pages 161-243

11. Adjunctive Antiarrhythmic Drug Therapy

    • Philip D. Henry, Antonio Pacifico

    Pages 245-257

12. Lead System Dysfunction, Diagnosis, and Therapy

    • Stephen Pavia, Walid Saliba, Bruce L. Wilkoff

    Pages 259-278

13. Device Proarrhythmia

    • Stephen Pavia, Sergio L. Pinski, Andrea Natale

    Pages 279-323

14. Electromagnetic Interference (EMI)

    • Mike Hardage, Philip D. Henry

    Pages 325-350

15. Anxiety and Depression

    • Philip D. Henry, Antonio Pacifico

    Pages 351-394

16. ICD Trial Appendix

    • Antonio Pacifico, Gust H. Bardy, Martin Borggrefe, Philip D. Henry, Francis E. Marchlinski, Andrea Natale et al.

    Pages 395-397

17. Back Matter

    Pages 399-410

    PDF

Implantable defibrillators as originally conceived by Michel Mirowski were limited to the detection and automatic termination of ventricular fibrillation. In the original "AID" device, the detection algoritlun sought to distinguish sinus rhytlun from ventricular fibrillation by identifying the "more sinusoidal waveform of ventricular fibrillation. " The therapeutic intervention was elicited only once deadly polymorphic rhythms had developed. It was rapidly learned, however, that ventricular fibrillation is usually preceded by ventricular tachycardia. Mirowski recognized the pivotal importance of developing algoritllms based on heart rate. Ventricular tachycardia detection allowed the successful development of interventions for the termination of ventricular tachyarrhythmias before they degenerated into ventricular fibrillation. Current device therapy no longer confines itself to tlle termination of chaotic rhythms but seeks to prevent them. Diagnostic algorithms moved upward along the chain of events leading to catastrophic rhytlulls. Rate smoothing algorithms were developed to prevent postextrasystolic pauses from triggering ventricular and atrial tachyarrhytlmlias. Beyond the renaissance of ectopy-centered strategies, long-term prevention received increasing attention. Multisite pacing therapies provided by "Arrhythmia Management Devices" were designed to reduce the "arrhytlunia burden" and optimize the synergy of cardiac contraction and relaxation. Clinical evidence now suggests that atrial fibrillation prevention by pacing is feasible and tllat biventricular pacing may be of benefit in selected patients with heart failure. However, these applications of device therapy that generally require ventricular defibrillation backup remain investigational and were not considered in this book.

• ICD
• arrhythmia
• complication
• complications
• depression
• diagnosis
• drug
• electrophysiology
• implant
• implantat
• implantation
• instrumentation
• physiology
• therapy
• training

• Baylor College of Medicine and Texas Arrhythmia Institute, Houston, USA

  Antonio Pacifico, Philip D. Henry

• University of Washington, Seattle, USA

  Gust H. Bardy

• Westfälische Universität, Münster, Germany

  Martin Borggrefe

• Allegheny University Hospitals, Philadelphia, USA

  Francis E. Marchlinski

• The Cleveland Clinic Foundation, Cleveland, USA

  Andrea Natale, Bruce I. Wilkoff

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