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Therapy with an implantable cardioverter defibrillator (ICD) in patients with coronary artery disease and dilated cardiomyopathy : benefits and disadvantages

Schaer, B. and Kühne, M. and Koller, M. T. and Sticherling, C. and Osswald, S.. (2009) Therapy with an implantable cardioverter defibrillator (ICD) in patients with coronary artery disease and dilated cardiomyopathy : benefits and disadvantages. Swiss medical weekly : official journal of the Swiss Society of Infectious Diseases, the Swiss Society of Internal Medicine, the Swiss Society of Pneumology, Vol. 139. S. 647-653.

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Official URL: http://edoc.unibas.ch/dok/A6004328

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Abstract

Contemporary guidelines refer to ICD implantation in patients who experienced ventricular tachycardia or fibrillation as secondary prevention, and in well-defined high risk groups as primary prevention. Randomised studies were performed in patients with coronary artery disease and in non-ischaemic cardiopathies, chiefly dilated cardiomyopathy. After four years' follow-up the absolute risk reduction was some 10% in secondary prevention and 8-20% in primary prevention, depending on the patient population. As only approx. 50% of ICD patients will receive appropriate therapies during long-term follow-up, reasonable risk stratification is crucial. However, apart from ejection fraction of >35%, all other echo- or electrocardiographic factors studied have thus far failed to have significant impact to determine risk in advance. In a retrospective analysis comorbidities such as advanced age, renal failure and atrial fibrillation have been shown to influence the effect of an ICD. During long term follow-up inappropriate shocks, lead complications, premature battery depletion and anxiety are some of the most significant problems for an ICD patient.
Faculties and Departments:03 Faculty of Medicine > Departement Klinische Forschung > Clinical Epidemiology and Biostatistics CEB > Klinische Epidemiologie (Bucher H)
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Kardiologie
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Kardiologie
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Kardiologie > Kardiologie Elektrophysiologie (Osswald)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Kardiologie > Kardiologie Elektrophysiologie (Osswald)
UniBasel Contributors:Osswald, Stefan and Sticherling, Christian and Schär, Beat and Koller, Michael
Item Type:Article, refereed
Bibsysno:Link to catalogue
Publisher:EMH
ISSN:1424-7860
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:24 May 2013 09:22
Deposited On:24 May 2013 09:04

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