The implantable automatic defibrillator: an update for emergency physicians

Martín Martínez A, Peinado Peinado R, González Torrecilla E, Ormaetxe Merodio J, Álvarez López M, Del Arco Galán C, Suero Méndez C

The implantable automatic defibrillator (IAD) represents a recentlyacquired

therapeutic option for the prevention and management of

ventricular arrhythmias and cardiac sudden death. A significant increase

of the indications for its use has occurred over the last few years

and, considering the increasing number of patients in whom an increased

risk of these most severe complications may today be identified,

there has been also an exponential increase in the number of device

implantations. Finally, the currently most advanced devices incorporate

further functions beyond that of triggering electric discharges, such as

arrhythmia event recording, anti-tachycardia or anti-bradycardia stimulation

functions, or cardiac resynchronisation therapy. It is thus of utmost

importance for the emergency physician to know the possibilities of this

new therapeutic tool in all acute-phase clinical scenarios. The present

review paper addresses those aspects with the greatest interest for the

emergency physicians in the context of clinical and electrophysiological

background, device function and current IAD indications.

Del Arco Galán C, González Torrecilla E, Martín Martínez A, Ormaetxe Merodio J, Peinado Peinado R, Suero Méndez C, Álvarez López M