Republished: The burden of inappropriate shocks in young people and how to avoid them

Implicated in up to half of all cardiovascular mortality among developed nations worldwide,^{w1 w2} sudden cardiac death (SCD) is associated with approximately 450 000 deaths annually in the USA and >700 000 deaths in Europe.^{w3 w4} In 23% of out-of-hospital and 17% of inhospital cardiac arrests, the initial observed rhythm was ventricular tachycardia (VT) or ventricular fibrillation (VF), both potentially treatable with defibrillation.^{w5 w6} Large scale trials have also demonstrated that implantable cardioverter defibrillators (ICDs) can improve survival through terminating malignant ventricular arrhythmias, particularly among SCD survivors^w7 and heart failure patients with systolic dysfunction.^w8–w12 Based on these data, there has been a dramatic surge in the utilisation of ICDs over the past two decades, with 116 000 ICD device implantations in the USA in 2009 alone, of which 53 000 (46%) were implanted in patients younger than the age of 65 years.^w6

With increasing use of ICDs, there has also been heightened awareness of device-related...

Source: http://pmj.bmj.com/cgi/content/short/88/1046/719?rss=1

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