Implantable Cardioverter Defibrillator Therapy for Primary Prevention of Sudden Cardiac Death-An Argument for Guideline Adherence

Sudden cardiac death is the leading cause of death among adults in the United States. Multiple randomized controlled trials have provided clear-cut data on appropriate subgroups of patients whose survival has improved through primary prevention therapy with an implantable cardioverter defibrillator. Current guidelines specify a class I indication in patients with reduced left ventricular ejection fractions with both ischemic and nonischemic cardiomyopathy under various conditions. Cardiac resynchronization therapy has also been demonstrated to reduce mortality in selected patient subgroups and should be combined with an implantable cardioverter defibrillator in appropriate patients. Adherence to these guidelines should result in a reduction in sudden-death mortality.