The implantable cardioverter-defibrillator as management of ventricular arrhythmias
The implantable cardioverter-defibrillator as management of ventricular arrhythmias
The implantable cardioverter-defibrillator (ICD) constitutes an integral part of the care of patients at risk of potentially lethal arrhythmias, because it is able to restore the heart’s normal rhythm by delivering therapies such as shocks. ICD care is increasingly becoming more individualized and personalized. With the research of Alwin Noordman aimed to determine the prognostic outcomes of patients with an ICD in daily practice and gain insight in which patients benefit most from an ICD.
We found that not all patients were at an equal risk of so-called appropriate ICD therapies, delivered for potentially lethal arrhythmias. Men, patients having a clear cause of their arrhythmia, and patients with a larger and less homogenous scar in those with a previous infarction were more likely to experience appropriate ICD therapies. Patients with an unclear cause had a higher risk of shocks delivered in the absence of potentially lethal arrhythmias, delivered inappropriately. We additionally found that ICD therapies were not always necessary, even though they were delivered appropriately. As a way of countering unnecessary and inappropriate therapies, we proposed a novel mobile application, giving patients the opportunity to avert impending unnecessary and inappropriate ICD therapies by pressing a button if they are still conscious. Finally, we investigated the role of imaging in ablation of potentially lethal arrhythmias. We found that CT imaging and information on the electrical properties of the heart may help in the identification of regions of interest and thus help reduce the risk of arrhythmias and hence ICD therapies.