SCIENTIFIC JOURNAL of the Hungarian Society of Cardiology

Changes in primary prevention ICD indications in the 2022 ESC guideline for the treatment of ventricular arrhythmias and prevention of sudden cardiac death

█ Review

DOI: 10.26430/CHUNGARICA.2023.53.4.375

Makai Attila, Sághy László
Szent-Györgyi Albert Klinikai Központ, Belgyógyászati Klinika, Szeged
Levelezési cím:
Dr. Makai Attila PhD, 6725 Szeged, Semmelweis u. 8. E-mail:

Primary prophylactic implantable cardioverter-defibrillators (ICDs) are devices for patients at high risk of sudden cardiac death due to ventricular tachyarrhythmias, but who have not previously experienced such an event. The primary prophylactic ICD aims to prevent sudden cardiac death (SCD) by detecting and treating life-threatening arrhythmias. ICDs have been shown to be effective in reducing the risk of SCD in individuals at high risk of ventricular tachyarrhythmias (e.g. with a history of myocardial infarction, heart failure or certain genetic diseases). ICDs have also been shown to be beneficial in patients at high risk of sudden cardiac death due to structural abnormalities or dysfunction of the heart. The benefit of using primary prophylactic ICDs is that they not only significantly reduce the risk of sudden cardiac death, but can also improve quality of life by reducing the fear of sudden cardiac death. ICDs have also been shown to be cost-effective in appropriately selected populations. However, primary prophylactic ICDs have potential drawbacks include the risk of infection or bleeding and the consequences of electrode damage or dislodgement. ICDs can also deliver inapproriate therapy, which can be painful and dangerous for the patient. Thus, the decision to implant an ICD should be made by the doctor and the patient together, taking into account the medical history, the risk factors, the potential benefits of implantation and the potential disadvantages of living with the device.


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