Indication of Implantable Devices for the Prevention of Sudden Cardiac Death

In Japan, implantable cardioverter-defibrillators (ICD) were approved by the Japanese Ministry of Health, Labor and Welfare (MHLW) in 1996. The first guidelines for ICD were published by the Japanese Circulation Society (JCS) in 2001, then a revised version was posed on JCS’s website in 2006. Cardiac-resynchronization therapy without (CRT-P) with (CRT-D) implantable defibrillators were then approved in 2004 and 2006, respectively. The implantation of ICD, CRT-D and CRT-P are useful for improving the prognosis and/or sudden cardiac death event rate in patients with heart failure and/or fatal ventricular arrhythmias (ventricular tachycardia: VT/ventricular fibrillation: VF). This review paper was written mainly to identify the indications for ICD/CRT-P or CRT-D on the basis of the 2006 JCS guidelines. Further, the usefulness of pharmacological tests for the choice of effective drugs to treat lethal arrhythmia and electrophysiological tests for prognosis, especially in patients with dilated cardiomyopathy, have been questioned recently. Thus, little attention was given to those factors in this paper. However, the presence structural heart disease and LVEF measurements were described in greater detail.