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Appraising Mortality Benefits of Implantable Cardioverter-Defibrillator in Post Myocardial Infarction Sudden Cardiac Death
  • Prima Hapsari Wulandari
Prima Hapsari Wulandari
Affiliation -Faculty of Medicine, Airlangga University

Corresponding Author:[email protected]

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Abstract

In the United States alone, sudden cardiac death (SCD) is responsible for nearly half of all the deaths associated with cardiovascular diseases. Acute myocardial infarction (AMI) survivors are at greater risk of SCD, mostly caused by severe left ventricular (LV) systolic dysfunction and cardiac arrhythmias. A device known as the automated implantable cardioverter-defibrillator (AICD) or implantable cardioverter-defibrillator (ICD) is implantable in the body, capable of delivering cardioversion, performing defibrillation, and (within some modern updates) pacing the heart. The all-cause mortality in patients with implanted ICD saw an adjusted reduction of 44% (HR 0.56, 95% CI: 0.32-1.01; P = 0.053)) in contrast to those with identical baseline. Subjects with implanted ICD three months following a myocardial infarction (MI) displayed insignificant greater mortality than those who did not implant an ICD. The factors favoring the implantation of ICD were, among many, elevated resting heart rate, multiple MIs, the occurrence of non-sustained ventricular tachycardia, syncope episodes, QRS duration of 120 milliseconds (ms), consumption of anti-arrhythmic medicine (often Class III), and MI index of longer than a year. The probability of obtaining an ICD depreciated as patients age. A notable predictor of death is extended periodic repolarization dynamics. To sum, cardioverter-defibrillators help decreases the mortality of all-cause and sudden cardiac death. It is noteworthy that ICDs are only meaningful if implanted following a sufficient post-MI period gap.