Sudden cardiac death, or cardiac arrest, is a problem that kills several hundred thousand Americans per year affecting both women and men. Effective treatment includes defibrillation, applying a shock to the heart to restore the rhythm. External defibrillators have been seen on T.V. and in the movies for years.
A person who has survived a cardiac arrest is a candidate for an implantable cardioverter defibrillator (ICD). The public became more aware of ICD's when vice president Richard Cheney received one several years ago. The ICD is a device implanted in a fashion similar to a pacemaker. It provides backup pacing capabilities (protection against slow rhythms), but more specifically provides direct protection against recurrent cardiac arrest with defibrillation capabilities (the ability to shock the heart back into rhythm).
While these devices have been exceedingly helpful in providing therapy for patients who have survived a cardiac arrest, the big issue is identifying people at high risk for cardiac arrest before one occurs.
Studies are now available, which demonstrate the effectiveness of ICD's, and have identified specific patient characteristics to help distinguish people at high risk for sudden cardiac death.
Risk factors include coronary atherosclerotic disease (blockages in the arteries), reduced ejection fraction (decreased pump function of the heart), short runs of irregular heart rhythms and/or a history of syncope (passing out).
These risk factors do not necessarily represent a need for an implantable cardioverter defibrillator, but rather the patient needs to discuss with their physician their medical condition, and if necessary, be referred for further appropriate electrophysiological investigation and/or therapy. Electrophysiology is the study of the electrical impulses of the heart.
The ICD does not replace the need for individuals to reduce their risk factors. The ICD is a therapy that should be in addition to discontinuing and avoiding tobacco use, adherence to a low fat low cholesterol diet and exercise. Reduction in risk factors for coronary disease will help keep the patient from proceeding into, and developing factors, for a high-risk group for sudden cardiac death.