RT Book, Section
A1 Upadhyay, Gaurav A.
A1 Singh, Jagmeet P.
A2 Fuster, Valentin
A2 Harrington, Robert A.
A2 Narula, Jagat
A2 Eapen, Zubin J.
SR Print(0)
ID 1161719439
T1 PACEMAKERS AND DEFIBRILLATORS
T2 Hurst's The Heart, 14e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071843249
LK accesscardiology.mhmedical.com/content.aspx?aid=1161719439
RD 2024/04/19
AB Cardiac  implantable  electronic  devices  (CIEDs),  notably  pacemakers  and  implantable  cardioverter-defibrillators  (ICDs),  represent  dramatic  technological  advances  that  have  become  essential  in  addressing  the  problems  of  arrhythmia  and  heart  failure  (HF)  in  modern  cardiovascular  patients.  Although  similar  in  design,  these  technologies  represent  two  distinct  paradigms  of  treatment.  Where  conventional  single  or  dual-chamber  pacemakers  are  used  to  address  the  fundamental  problem  of  bradyarrythmia,  ICDs  are  designed  to  automatically  detect  and  treat  tachyarrhythmias,  specifically  hemodynamically  unstable  ventricular  tachycardia  (VT)  or  ventricular  fibrillation  (VF).  In  the  past  two  decades,  a  third  paradigm  has  also  emerged—cardiac  resynchronization  therapy  (CRT)—in  which  biventricular  (BiV)  pacing  is  used  to  improve  left  ventricular  (LV)  pump  function  in  patients  with  intraventricular  conduction  delay  and  systolic  HF.  Along  with  developments  in  fundamental  approaches  to  pacing  and  defibrillation,  recent  years  have  also  brought  about  exciting  advances  in  design,  with  the  development  of  leadless  pacing  and  subcutaneous  defibrillators.  The  purpose  of  this  chapter  is  to  provide  an  overview  on  pacing,  defibrillation,  and  the  indications  for  specific  types  of  devices,  and  to  review  seminal  clinical  trials  supporting  their  use  in  clinical  practice.