IMPLANTABLE CARDIOVERTER-DEFIBRILLATORS

Indications

ICDs have become first-line therapy in patients who have survived an episode of VF not associated with acute myocardial infarction or who have had an episode of hemodynamically significant, sustained VT. ICDs are also implanted in individuals at high risk for cardiac arrest, including patients with idiopathic, dilated cardiomyopathy and unexplained syncope or patients with coronary artery disease (CAD), an ejection fraction less than 35%, spontaneous episodes of nonsustained VT, and inducible sustained VT in the electrophysiology laboratory. Based on the results of large-scale clinical trials, the indications for implantation of an ICD were recently expanded to include patients with a previous myocardial infarction and an ejection fraction of 30% or less, as well as patients with dilated cardiomyopathy (ischemic or nonischemic), an ejection fraction of 35% or less, and class II or III heart failure. [5] [6] [7]


Fuente: Cecil 23 ed

Se considera indicacion de DAI

1. Extrasistoles ventriculares complejos sintomaticos en pacientes sin cardiopatia. -> NO
2. Taquicardia ventricular incesante -> NO (seria correcta si dijera en laboratorio de electrofisiologia)
3. Fibrilacion ventricular que ocurre en la primera hora tras un IAM. -> NO
4. Parada cardiaca por fibrilacion ventricular en paciente con infarto de miocardio cronico anterior extenso. -> SI
5. Sincopes de repeticion en paciente con estudio cardiologico normal -> NO