[Implantable defibrillators. Role of the defibrillator in treatment and prevention of sudden death]

Several studies have demonstrated that implantable defibrillators improve survival in patients with a very high risk of sudden death. INDICATIONS FOR PRIMARY PREVENTION: The most obvious indication is for young patients with severe recurrent rhythm disorders and generally good left ventricular function. However, most of the candidates have severe left ventricular dysfunction due to post infarction ischemia or dilated cardiomyopathy who develop syncopal or hemodynamically poorly tolerated ventricular tachycardia or who have survived a first episode of sudden death. PROPHYLACTIC INDICATIONS: Automatic defibrillation should be proposed for patients with factors of risk of sudden death such as left ventricular dysfunction or infarction sequelae.