[The implantable cardioverter-defibrillator: sometimes necessary]

Abstract

The implantable cardioverter-defibrillator (ICD) is used in patients who are at risk for ventricular fibrillation after having suffered from a myocardial infarction. Initially, patient selection was limited to survivors of impending sudden death with coronary artery disease. Later, ICD implantation in high-risk coronary artery disease patients was found to lower cardiovascular mortality. More recently, patients with dilated cardiomyopathy and no coronary artery disease are also potential candidates for implantation of an ICD. In the Netherlands, it is expected that there will be 1-2 ICD-users per 10,000 inhabitants. This means that ambulance personnel, general practitioners and doctors in emergency wards will also be confronted with patients who have had one or more shock treatments. Such medical personnel should have knowledge about the function of the ICD, what to do if several shocks have been given and whom to contact in case problems persist.