Nearly 450 000 individuals experience sudden cardiac death yearly in the United States. A history of prior myocardial infarction with resultant left ventricular dysfunction identifies a group at particularly high risk of sudden arrhythmic death. Implantable cardioverter-defibrillators have proven highly effective at reducing this risk and are now increasingly implanted in patients with this risk profile. The case of Mr M, a 59-year-old man with a history of myocardial infarction, low ejection fraction, and mild congestive heart failure, who is considering implantable cardioverter-defibrillator placement, illustrates the issues in having a device implanted as a prophylactic measure as well as increasing concerns due to device recalls and malfunction. A thorough discussion of the benefits and risks associated with this therapy is necessary for patients and physicians to make appropriate decisions with regard to the primary prevention of sudden death.
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Recordings downloaded from the log of an ICD in 2 separate patients. A, Recording demonstrates an episode of ventricular fibrillation (VF) sensed by the ICD and treated with a defibrillation. VS indicates sensing of ventricular event; VP, delivery of pacing pulse. B, Recording demonstrates an episode of ventricular tachycardia treated with rapid ventricular pacing (antitachycardia pacing). TF indicates detection of heart rate consistent with ventricular tachycardia; TP, delivery of pacing pulse; VS, sensing of ventricular event; FS, sensing of fibrillation event. Letters in the abbreviations read vertically in panel B.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and
Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early
dhildhood mortality and growth failure data and their association with maternal
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