Archive for the ‘ICD’ Category

ICDs are primarily life saving devices.Whether single or dual chamber  it does this function  effectively.They will also  take care of  bradycardia by  default  back up pacing .For most indications single chamber ICDs are good enough.

My professor used to tell us , dual lead  means ,  dual expertise , dual cost , dual caution and  dual set of complication . One should avoid it whenever possible. Make things as simple as  it could be , without compromising the main goal (Here prevention of SCD) . The incidence of inappropriate shocks being lesser with dual chamber ICD  has not been truly  realised in real world scenario.

Recent studies  tend to give  credence to this  perception .(Peterson JAMA 2013)

Dual  Chamber ICDs  may have an edge only in few situations .

  • When there are both indication for pacing as well as ICD like heart block and LV dysfunction.
  • In extreme LV dysfunction were benefits of dual chamber pacing may have advantage.(If CRT is not an option )


1 .Peterson PN, Varosy PD, Heidenreich PA, et al. Association of single- vs dual-chamber ICDs with mortality, readmissions, and complications among patients receiving an ICD for primary prevention. JAMA 2013; 309:2025-2034.

2.Medscape review


single vs dual chamber pacing indication



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