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NICE guidance on implantable defibrillators

Date published: 26/01/2006

The National Institute for Health and Clinical Excellence (NICE) has given its advice on implantable-cardioverter defibrillators (ICDs), doubling the number of people eligible to have them. The potentially life saving devices are used with people at risk of sudden cardiac death (SCD) as a result of cardiac arrhythmias (irregular heart rhythms).

Professor David Barnett, chair of the appraisal committee that produced the guidance, said: "We have reviewed our guidance on the use of ICDs in light of new evidence relating to the risk factors for sudden cardiac death. "The effect of this has been to increase the range of risk factors that clinicians can use in order to assess an individual's suitability for an ICD. This may reduce the requirement for more complex testing in these cases."

Dr Derek Connelly, president of the physician group Heart Rhythm UK, welcomed the NICE guidance. He said: "NICE's new guidance on ICDs is good news for those at risk of sudden cardiac arrest, which currently kills 90,000 people every year in the UK. "It means that, going forward, many more people with heart conditions that make them especially prone to sudden cardiac arrest should be fitted with ICDs prophylactically."

However, he warned that the NHS needed to have a clear direction over their use. Dr Connelly added: "Without a clear steer from the NHS, the guidance will likely languish and end up having a negligible impact on clinical practice. That would be more than a shame. After all, people's lives are at stake."

ICDs are similar in size to pacemakers and deliver a small electric shock to the heart when they sense an irregular heart rhythm. In the UK since the mid-1990s about 20,000 people have been fitted with ICDs, a number much lower than in Europe or the US.

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