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Soo Kim, J. Fisher, S. Furman, J. Gross, P. Zilo, J. Roth, K. Ferrick, Richard Brodman (1991)
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When "sudden cardiac death" is not so sudden: lessons learned from the automatic implantable defibrillator.American heart journal, 115 1 Pt 1
Introduction Implantable cardioverter defibrillators (ICDs) are highly effective in preventing sudden death in patients with malignant ventricular arrhythmias. This therapy, pioneered by Mirowski et al.,' may be one of the most important advances in modern cardiology. Sudden death rates may be as low as 2%-3% per year with the ICD therapy. The benefits of the therapy in reducing sudden deaths have been widely reported by many investigaand publicized by manufacturers of defibrillators. It has also been noted that nonsudden cardiac death rates remain substantial in these patients.2-s It is commonly believed that nonsudden cardiac deaths in these patients are mostly due to the progression of underlying heart disease unrelated to the arrhythmias. However, nonsudden cardiac deaths in these patients include surgical mortality after ICD implantation and arrhythmiarelated nonsudden cardiac death.6" In fact, about 50% of nonsudden cardiac deaths may be causally related to arrhythmias." Therefore, sudden death rates appear to be an inadequate indicator for assessing the benefits and risk of ICD therapy.6 Address for reprints: So0 G. Kim. M.D., Division of Cardiology, Arrhythmia Service, Montefiore Medical Center, 11 1 East 210th Street, Bronx. NY 10467. Fax: (212) 920-6798. Submitted for publication August 27, 1991; accepted for publication
Journal of Interventional Cardiology – Wiley
Published: Dec 1, 1991
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