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ClearRounds Health · Cardiology · Quick Reference

ICDs

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Arrhythmias & DevicesIntermediateIn progressOne-page PDF

Primary/secondary prevention, EF timing, shocks, ATP, driving/work considerations, device checks, and urgent issues.

Last reviewed

Pending initial clinical review

Sources / guidelines to verify

  • 2017 AHA/ACC/HRS Ventricular Arrhythmias & SCD Guideline
  • Driving-restriction consensus statements
Disclaimer: Educational reference only. Not a substitute for clinician judgment, local protocols, or current guideline review.

One-page reference

Draft content pending the site owner’s clinical review. Verify against the sources above and local protocol before clinical use.

1

What it is / why it matters

  • Detects and treats VT/VF with anti-tachycardia pacing (ATP) or shock.
  • Primary prevention (low EF) vs secondary prevention (prior VT/VF/arrest).
2

Key diagnostic clues

  • Primary prevention: EF ≤35% (≥40 days post-MI / ≥3 months on GDMT).
  • Secondary prevention: survivors of VT/VF/arrest; certain genetic/structural conditions.
3

Initial workup

  • Confirm indication and EF after optimal GDMT; CRT-D if CRT criteria met.
  • Shared decision-making (shocks, driving, end-of-life deactivation).
4

Management framework

  • ATP (painless) then shock; routine device interrogation and remote monitoring.
  • Driving/occupational restrictions per local rules.
5

Red flags / escalate now

  • A single shock + patient well → urgent outpatient interrogation.
  • Multiple shocks / electrical storm → EMERGENT (VT storm, ischemia, lead issue, or inappropriate shock from AF/noise).
6

Follow-up / monitoring

  • Interrogation, GDMT optimization, and psychosocial support.
7

Clinic pearls

  • Reassess EF after ≥3 months of GDMT before a primary-prevention ICD.
  • Multiple shocks = emergency; inappropriate shocks often come from rapid AF or lead noise.

Related quick references

📄 Pacemakers📄 Ventricular Tachycardia / Ventricular Fibrillation📄 HFrEF

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ClearRounds Health · Cardiology — ICDs Quick Reference · Last reviewed: Pending initial clinical review · Educational reference only. Not a substitute for clinician judgment, local protocols, or current guideline review.