Role of coronary revascularisation among patients receiving implantable defibrillators: a review

International Journal of Cardiology
Karthik ViswanathanM H Tayebjee

Abstract

Patients with coronary artery disease (CAD) can present with spontaneous ventricular arrhythmias occurring outside the context of an acute coronary syndrome with no apparent identifiable reversible cause. In addition to secondary prevention medications, implantable cardiac defibrillator (ICD) remains the main therapeutic intervention to reduce the risk of subsequent mortality and morbidity. Investigations prior to ICD implantation may identify the presence of angiographically significant epicardial coronary stenoses in previously asymptomatic patients, alongside other arrhythmic substrates such as myocardial scar and impaired left ventricular systolic function. So does coronary revascularisation in these patients reduce the occurrence of appropriate ICD shocks in the long run? In this article we comprehensively review the literature to answer the primary question of whether coronary revascularisation reduces recurrent ventricular arrhythmia burden among patients with CAD receiving an ICD, with focus on those presenting with ventricular arrhythmias outside the context of acute coronary syndrome. With growing evidence of the adverse prognostic impact of appropriate ICD discharges and an ever-increasing number of ICD implants worl...Continue Reading

References

Sep 15, 1991·The American Journal of Cardiology·C J PepineS O Gottlieb
Jan 17, 2002·The New England Journal of Medicine·H V HuikuriR J Myerburg
Oct 8, 2003·Circulation·Alida E Borger van der BurgMartin J Schalij
Dec 8, 2004·Circulation·Arthur J MossUNKNOWN Multicenter Automatic Defibrillator Implantation Trial-II (MADIT-II) Research Group
May 10, 2006·Journal of the American College of Cardiology·Ilan GoldenbergUNKNOWN MADIT-II Investigators
Aug 7, 2007·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Edward J CiaccioJames Coromilas
Sep 5, 2008·The New England Journal of Medicine·Jeanne E PooleGust H Bardy
Feb 27, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Michael O SweeneyBruce L Wilkoff
Jul 14, 2010·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Alon BarsheshetVictor Guetta
Apr 6, 2011·The New England Journal of Medicine·Eric J VelazquezUNKNOWN STICH Investigators
Apr 6, 2011·The New England Journal of Medicine·Robert O BonowUNKNOWN STICH Trial Investigators

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