icd_implantation_gen_arrhythmia_gencard_final

Document Sample
icd_implantation_gen_arrhythmia_gencard_final Powered By Docstoc
					     ICD Implantation:
Genetic Arrhythmia Syndromes


       William M. Miles, MD, FHRS
  University of Florida College of Medicine
               Gainesville, FL
 Genetic Arrhythmia Syndromes



   Long- and short-QT syndromes
   Brugada syndrome
   Idiopathic VF
   Catecholaminergic polymorphic VT

Most of these patients have no evidence of structural heart
disease or LV dysfunction, and long-term prognosis is
excellent if the arrhythmia is controlled.




                                                    www.HRSonline.org
Indications for ICD Implantation:
Genetic Arrhythmia Syndromes


ICD may be considered (Class IIb)
  Primary prevention
    • Patients with long QT syndrome and risk factors for SCD
          e.g. markedly prolonged QTc or T wave alternans, “malignant” mutation




                                                                         www.HRSonline.org
Indications for ICD Implantation:
Genetic Arrhythmia Syndromes



ICD implantation is indicated (Class I)
  Secondary prevention
    • Survivors of cardiac arrest after exclusion of completely
      reversible causes
ICD implantation is reasonable (Class IIa)
  Secondary prevention
    • Patients with long-QT syndrome who are having syncope and/or
      VT while receiving beta blockers
    • Patients with Brugada syndrome who have had
         • Syncope
         • Documented VT that has not resulted in cardiac arrest
    • Patients with catecholaminergic polymorphic VT with syncope
      and/or sustained VT while receiving beta blockers


                                                                   www.HRSonline.org

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:3
posted:8/27/2012
language:
pages:4