The Use of ICDs in Post-Infarction Patients

John Fisher; Bruce Wilkoff; Charles Love

The Use of ICDs in Post-Infarction Patients

Moderator:

John Fisher, MD

Albert Einstein College of Medicine

Discussants:

Date: August 2, 2011

Roundtable ID: CV004

Citation: Med Roundtable Cardiovasc Ed. ; 3(1): 61 - 67.

Summary:
Dr. John D. Fisher from the Albert Einstein College of Medicine and Montefiore Medical Center moderated the topic "The Use of ICDs in Post-Infarction Patients" with Drs. Charles J. Love from the Ohio State University Medical Center and Bruce L. Wilkoff from the Case Western Reserve University and the Cleveland Clinic.

The discussion focused primarily on:

(1) the use of ICDs in post-infarction patients;

(2) how soon after infarction should an ICDs be implanted;

(3) improving survival in post-infarction patients;

(4) the use of revascularization and PCI;

(5) advantages and disadvantages of ICDs;

(6) patient specific considerations; and

(7) guidelines for the use of ICDs.

(Med Roundtable Cardiovasc Ed. 2012;3(1):61-67) ©2011 FoxP2 Media, LLC

Compounds:
No compounds discussed.

Trials:
MADIT-II, CABG Patch, AVID, DINAMIT, IRIS

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"These are guidelines created to guide people in decision making, but there is latitude based on patients’ underlying medical conditions, underlying psychiatric conditions, and other issues that may come into play, and all of these things need to be considered."
~ John D. Fisher, MD

"We get this mixed bag and if we try to prophylactically implant devices in this group we do reduce arrhythmic death but we don’t reduce total mortality."
~ Charles J. Love, MD

"There are risks associated with [ICDs] as well, and making that decision in the time period where making it a hurry-up decision is probably not the best long-term emotional, psychological, or social way of going about doing this."
~ Bruce L. Wilkoff, MD