November 2021 Br J Cardiol 2021;28:134–38 doi:10.5837/bjc.2021.048
Patrick Tran, Leeann Marshall, Ian Patchett, Handi Salim, Shamil Yusuf, Sandeep Panikker, Michael Kuehl, Faizel Osman, Prithwish Banerjee, Harpal Randeva, Tarvinder Dhanjal
Abstract
Introduction
Implantable cardiac defibrillators (ICDs) have become the cornerstone in preventing sudden cardiac death in susceptible patients or survivors of malignant ventricular arrhythmias (VAs).1-3 Although they terminate VA and improve survival, there is still a risk of recurrent VAs and ICD shocks, which are associated with profound psycho-social stress, worsening heart failure (HF) and increased mortality.2-4
Several strategies are available to address this, with specific advantages and risks. Programming to delayed-detection therapy windows can attenuate ICD therapy risk, but do not completely eliminate shocks.5 Anti-arrhythmic drugs
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