Who should receive an implantable cardioverter-defibrillator after myocardial infarction?

The Role of Preventive Ablation of Ventricular Tachycardia in the Patient with Coronary Artery Disease, Reduced Left Ventricular Function, and a New Implantable Cardioverter Defibrillator Implant

Most patients referred for ventricular tachycardia (VT) ablation have already suffered multiple therapies for recurrent VT, typically in the form of implantable cardioverter defibrillator (ICD) shocks. Recent landmark trials have looked at these populations and suggest potential usefulness of early, preventive ablation of VT in patients with ischemic cardiomyopathy. In this review the potential role of early VT ablation in patients with ischemic cardiomyopathy, current controversies regarding VT ablation in this population, and ongoing and future research that may further inform clinical decision making regarding optimal timing of ablation in these patients are discussed.

Indications for implantable cardioverter-defibrillator placement in ischemic cardiomyopathy and after myocardial infarction

Dramatic reductions in the rate of sudden cardiac death due to use of implantable cardioverter-defibrillators (ICDs) have been well-established in several large randomized clinical trials including patients with left ventricular dysfunction after myocardial infarction. This article reviews the literature regarding ICD utilization in the postinfarction population, with a strong emphasis on recent clinical trials. The most current indications for, and timing of, ICD implantation postinfarction also are summarized.