Considerazioni sulle raccomandazioni delle linee guida all'Impianto del cardioverter-defibrillatore per la prevenzione primaria della morte cardiaca improvvisa nei pazienti con grave disfunzione ventricolare. Documento di consenso dell'Assoc. Naz. Medici Cardiologi Ospedalieri (ANMCO)/Società Italiana di Cardiol. (SIC)/Assoc. Italiana di Aritmologia e Cardiostimolazione (AIAC)

Translated title of the contribution: Discussions on the guideline recommendations for implantable cardioverter-defibrillator for the primary prevention of sudden cardiac death in patients with severe ventricular dysfunction. Consensus Document of the National Association of Hospital Cardiologists (ANMCO)/Italian Society of Cardiology (SIC)/Italian Association of Arrhythmology and Cardiac Pacing (AIAC)

Massimo Zoni Berisso, Maria Grazia Bongiorni, Antonio Curnis, Valeria Calvi, Domenico Catanzariti, Fiorenzo Gaita, Michele Massimo Gulizia, Giuseppe Inama, Maurizio E. Landolina, Maria Teresa La Rovere, Roberto Mantovan, Giosuè Mascioli, Eraldo Occhetta, Luigi Padeletti, Jorge A. Salerno-Uriarte, Massimo Santini, Biagio Sassone, Michele Senni, Massimo Zecchin

Research output: Contribution to journalArticle

Abstract

The indications for implantable cardioverter-defibrillator (ICD) therapy for the prevention of sudden cardiac death in patients with severe left ventricular dysfunction have rapidly expanded over the last 10 years on the basis of the very satisfying results of the numerous randomized clinical trials that have provided the framework for guidelines. However, the analysis of clinical practice in the real world has highlighted some important criticisms in the complex process of selection-management of those patients candidates for ICD therapy: 1) approximately one fourth of all ICD implantations is not justified by clinical evidence, 2) approximately one half of patients with an indication for ICD therapy do not undergo implantation, 3) the benefits from ICD therapy do not apply uniformly to all patients, 4) the relationship between the lifesaving benefit and the potential for harm of ICD therapy is still scarcely known. The main reason for this clinical scenario can be ascribed to the guideline recommendations that are based only on few standard cut-off criteria and therefore too generic and insufficiently detailed. This does not help cardiologists in their decisionmaking process, and results in fear, uncertainty, and sometimes emotional choices. The aim of this consensus document is to discuss current guideline recommendations and to provide the Italian cardiologists with the most updated information to optimize the selection of patients with severe left ventricular dysfunction who should receive ICD therapy.

Original languageItalian
Pages (from-to)752-772
Number of pages21
JournalGiornale Italiano di Cardiologia
Volume14
Issue number11
Publication statusPublished - Nov 2013

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Berisso, M. Z., Bongiorni, M. G., Curnis, A., Calvi, V., Catanzariti, D., Gaita, F., Gulizia, M. M., Inama, G., Landolina, M. E., La Rovere, M. T., Mantovan, R., Mascioli, G., Occhetta, E., Padeletti, L., Salerno-Uriarte, J. A., Santini, M., Sassone, B., Senni, M., & Zecchin, M. (2013). Considerazioni sulle raccomandazioni delle linee guida all'Impianto del cardioverter-defibrillatore per la prevenzione primaria della morte cardiaca improvvisa nei pazienti con grave disfunzione ventricolare. Documento di consenso dell'Assoc. Naz. Medici Cardiologi Ospedalieri (ANMCO)/Società Italiana di Cardiol. (SIC)/Assoc. Italiana di Aritmologia e Cardiostimolazione (AIAC). Giornale Italiano di Cardiologia, 14(11), 752-772.