Secondary prevention of sudden death:
This is prevention of sudden death after an event such as:
1) Survival 'sudden cardiac death' (SCD) due to VT or VF after successful resuscitation, if NOT provoked by an acute myocardial infarction or by a reversible cause (electrolyte disturbance, drugs, trauma).
2) Syncope or abrupt presyncope + spontaneous documented non-sustained or sustained VT with:
- with underlying structural heart disease
- without underlying structural heart disease, but not suitable for other therapy (explicitly state the reason why medication or ablation is not possible).
3) Syncope without documented tachyarrhythmia in patients with structural heart disease + inducible sustained VT/VF during EFO.
Primary prevention of sudden death:
This is a preventive implantation of an ICD without ever having previously documented an event or serious ventricular arrhythmia in a patient with underlying chronic severe heart disease with an increased risk of sudden death, such as:
- ischemic cardiomyopathy, without revascularizable ischemia, at least 40 days after an acute myocardial infarction or more than 3 months after successful revascularization and persistent:
- LVEF ≤ 30% + NYHA class I
- LVEF ≤ 35% + NYHA class II or III
- LVEF ≤ 40% + spontaneous non-sustained VT + inducible sustained VT/VF during EFO
- non-ischemic cardiomyopathy with LVEF ≤ 35% + NYHA class II - III despite optimal heart failure therapy for more than 3 months. The prognostic benefits are less significant than in patients with ischemic cardiomyopathy.
- Familial or genetic condition with a known associated risk of ventricular arrhythmias, and an increased risk of sudden death for the patient in question based on internationally accepted risk stratification (long QT syndrome, Brugada syndrome, hypertrophic cardiomyopathy, arrhythmogenic right ventricular dysplasia,... ).
And an expected life expectancy of more than 1 year in a good general, functional condition.
