The progressive understanding of the diseases associated with significant risk for
sudden cardiac death has fostered the development of early diagnosis and risk stratification.
Thus, instead of starting from either a sudden death victim or a survivor of a cardiac
arrest, it has become relatively common for cardiologists to identify individuals
at high risk for sudden death, often after an arrhythmic nonlethal cardiac event such
as syncope. Besides ischemic heart disease, it has also been recognized that children
and young adults can be affected by arrhythmogenic disorders of genetic origin with
a high propensity for lethal arrhythmias. Although β-blockers represent often the
first treatment of choice, they are not always sufficiently effective, and additional
protection is required. This has led to the widespread use of the implantable cardioverter-defibrillator
a (ICD), a very effective device that is, however, burdened by a significant number
of adverse side effects, especially common in the young. Hence, the necessity of considering—for
those patients who may not have an absolute indication for an ICD and for whom the
benefit-to-risk ratio is less than ideal—alternate strategies, especially if they
do not represent an obstacle for subsequent ICD implant.
Keywords
Abbreviations:
CPVT (catecholaminergic polymorphic ventricular tachycardia), ICD (implantable cardioverter-defibrillator), LCSD (left cardiac sympathetic denervation), LQTS (long QT syndrome)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 10, 2010
Accepted:
March 25,
2010
Received:
February 26,
2010
Identification
Copyright
© 2010 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.
