This post , is probably not meant for cardiology professionals.
Few technologies are clear winners in modern medicine. ICDs play games that would rival the God !
What is an ICD ?
Here is a man , who drops almost dead by a fatal cardiac arrhythmia . In few seconds ICD machine recognises this arrhythmia ,charges itself and fires a shock of about 30 joules direct current .The arrhythmia is reverted and the fellow gets up as if nothing has happened !
Watch this video
This revolutionary devices are to be used judiciously in individuals with high risk for dangerous cardiac arrhythmia.
The current indications as on 2012
Post MI ( Only after 4O days*)
LV dysfunction EF ≤ 35% NYHA II or III ( Please note , If ≤ 30%, even Class I NYHA can be implanted an ICD) *Why 40 days ? Residual ischemic, Irritable focus should settle down
Myocardial disease
- Nonischemic DCM EF ≤ 35% with documented VT
- Rarely other structural heart disease with recurrent risk for VT ( Few HCMs)
Primary electrical disease
- Survivors of cardiac arrest due to VF without any completely reversible causes (Includes Brugada )
- Malignant forms of syncope with idiopathic recurrent VT /VF
- Congenital Long QT syndromes not amenable to beta blockers
Reference
Dr.S.Venkatesan MD 
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