INDICATIONS OF IMPLANTABLE DEFIBRILLATORS

The automatic implantable defibrillator is an effective therapeutic to ol for palliative treatment of severe ventricular arrhythmias. There i s a significant reduction in sudden death in implanted patients. Howev er, reliable data on the long term global mortality is not yet availab le. The indications are difficult to define apart from special cases. A large number of factors has to be taken into consideration : the cli nical presentation of the arrhythmia, and the different medical and no n-medical therapeutic options. At present, it is not possible to arriv e at a consensus on the indications of automatic implantable defibrill ators. Therefore, it is illusory to construct decisional algorithms. T he authors suggest therapeutic orientations rather than strict clinica l indications, based on recommendations published by the working group s on cardiac arrhythmias and pacing of the European Society of Cardiol ogy and on their own personal experience.