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Practitioners use the terms sudden cardiac arrest (SCA) and sudden cardiac death interchangeably; however, their definitions are distinct. Sudden cardiac arrest is the sudden cessation of cardiac activity leading to an unresponsive victim who cannot breathe normally and does not have signs of functional circulation. If the condition is not addressed immediately, sudden cardiac arrest progresses to sudden cardiac death. In some patients, the placement of an implantable cardiac defibrillator significantly reduces the risk of sudden cardiac death. This activity describes the implantable cardiac defibrillator's indications, contraindications, and complications. It highlights the role of the interprofessional team in the management of patients who are at high risk for sudden death. Objectives: Identify the indications for an implantable cardiac defibrillator. Determine the contraindications to implantable cardiac defibrillators. Evaluate the complications of implantable cardiac defibrillators. Communicate interprofessional team strategies for optimizing care coordination and communication to advance the management of and outcomes for patients at high-risk for sudden cardiac arrest via the appropriate utilization of implantable cardiac defibrillators. Access free multiple choice questions on this topic.

Practitioners use the terms sudden cardiac arrest (SCA) and sudden cardiac death interchangeably; however, their definitions are distinct. Sudden cardiac arrest is the “sudden cessation of cardiac activity so that the victim becomes unresponsive, with no normal breathing and no signs of circulation.” If the condition is not addressed immediately, sudden cardiac arrest progresses to sudden cardiac death. Sudden cardiac death is defined “as a natural death due to cardiac causes, heralded by abrupt loss of consciousness.” Out-of-hospital cardiac arrest occurs outside of the hospital, and emergency medical services personnel most commonly attend to patients in these situations. There are approximately 356,500 out-of-hospital cardiac arrests per year in the United States.[1][2][3]

Complications are mainly related to ICD implantation and are uncommon but may include: Infection at the implant site that may extend from a mild reaction and seroma up to suppuration and necessitates lead extraction Allergic reaction to medications used during the procedure Bleeding or bruising where your ICD was implanted Damage to the vein where your ICD leads are placed In rare cases, upper limb deep vein thrombosis (DVT) Bleeding around the heart, which can be life-threatening. It may include pericardial effusion and may lead to tapping and surgical intervention Pneumothorax during the procedure of implantation.

The cardiologist or cardiac surgeon often performs ICD implantation. However, the primary care provider often cares for these patients. These healthcare professionals should closely monitor the patients for shocks and arrhythmias. Any adverse event should be referred promptly to a cardiologist. In addition, any patient who is a survivor of cardiac arrest, has structural heart disease, Unexplained syncope, Ischemic cardiomyopathy, Non-ischemic dilated cardiomyopathy, LV dysfunction due to prior MI, or has Non-sustained VT should be referred to a cardiologist to determine if they are candidates for an ICD.