Implantable Cardioverter-Defibrillators in End-Stage Renal Disease

Patel, Mehul B.; Hiremath, Swapnil; Contractor, Tahmeed; Thakur, Ranjan K.

doi:10.1016/j.ccep.2011.08.007

« Previous Next »Cardiac Electrophysiology Clinics
Volume 3, Issue 4 , Pages 641-650, December 2011

Implantable Cardioverter-Defibrillators in End-Stage Renal Disease

Mehul B. Patel, MD
- Department of Clinical Cardiac Electrophysiology, The Bay Pines Veterans Affairs Health Care System, University of South Florida, Tampa, 10000 Bay Pines Boulevard, Bay Pines, FL 33744, USA
Swapnil Hiremath, MD, MPH
- Division of Nephrology, The Ottawa Hospital, Riverside Campus, Ottawa, ON K1H 7W9, Canada
Tahmeed Contractor, MD
- Department of Clinical Cardiac Electrophysiology, Thoracic and Cardiovascular Institute, Sparrow Health System, Michigan State University, 405 West Greenlawn, Suite 400, Lansing, MI 48910, USA
Ranjan K. Thakur, MD, MPH, MBA, FHRS
- Department of Clinical Cardiac Electrophysiology, Thoracic and Cardiovascular Institute, Sparrow Health System, Michigan State University, 405 West Greenlawn, Suite 400, Lansing, MI 48910, USA
- Corresponding author.

Cardiovascular disease accounts for 41% of all-cause mortality in end-stage renal disease (ESRD), with sudden cardiac death (SCD) accounting for two-thirds of these patients. Although implantable cardioverter-defibrillators (ICDs) prevent SCD, little is known about their efficacy in ESRD because such patients have been excluded from major randomized controlled trials (RCTs). Some small, single-center retrospective analyses suggest that ESRD patients may not benefit as much as normal renal function patients whereas other studies suggest the opposite. Given the gaps in our understanding of SCD in ESRD and the clinical equipoise regarding ICD efficacy, an RCT is the next logical step.

Keywords: Implantable cardioverter-defibrillator, End-stage renal disease, Sudden cardiac death, Randomized controlled trials