ICD Implantation in Cardiac Amyloidosis: How It Works & When It’s Used

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ICD implantation in cardiac amyloidosis may be considered when a patient is at clinically important risk of potentially life-threatening ventricular arrhythmias. An implantable cardioverter-defibrillator, or ICD, continuously monitors the heart rhythm and can deliver antitachycardia pacing or an electrical shock when it detects certain dangerous ventricular tachyarrhythmias.

However, ICD use in cardiac amyloidosis requires particularly careful assessment. Although ventricular tachycardia and ventricular fibrillation can occur, sudden death in advanced amyloid cardiomyopathy can also result from severe pump failure or electromechanical dissociation—mechanisms that an ICD cannot correct (1, 2).

For this reason, the diagnosis of cardiac amyloidosis alone is not an indication for ICD implantation. Current expert guidance recommends using established ICD indications together with individualized assessment of arrhythmic risk, amyloid type, disease stage, competing causes of death and expected clinical benefit (1).

Key principle: An ICD can detect and treat selected ventricular tachyarrhythmias, but it does not treat the underlying amyloidosis and cannot prevent every mechanism of sudden death in cardiac amyloidosis.

What Is an Implantable Cardioverter-Defibrillator?

An implantable cardioverter-defibrillator is a small battery-powered cardiac device that continuously monitors the heart rhythm. When it identifies a programmed dangerous rhythm, the device can deliver therapy designed to restore a more stable rhythm.

A conventional transvenous ICD generally consists of two main components:

Pulse generator: the battery and electronic circuitry, usually implanted beneath the skin in the upper chest.
Lead or leads: insulated wires that pass through a vein into the heart and allow the device to sense electrical activity and deliver therapy.

Many ICDs also provide pacemaker functions. Therefore, the same device may be able to treat both dangerously fast ventricular rhythms and clinically important slow heart rhythms, depending on the system and its programming.

A subcutaneous ICD is different. It is implanted beneath the skin without a lead placed inside the heart. This can avoid long-term transvenous lead complications, but it does not provide the same chronic bradycardia pacing or antitachycardia pacing capabilities as a conventional transvenous ICD.

How Does an ICD Work?

The ICD monitors every heartbeat and analyzes the rate and electrical pattern. The electrophysiology team programs specific detection zones so the device can distinguish ordinary heart rates from rhythms that may require treatment.

When a potentially dangerous ventricular rhythm occurs, the ICD may respond in different ways depending on the rhythm and device programming.

Antitachycardia Pacing

For some episodes of ventricular tachycardia, the ICD can deliver a sequence of rapid, low-energy pacing impulses. This is called antitachycardia pacing (ATP).

The goal is to interrupt the abnormal electrical circuit and restore a normal rhythm without delivering a shock. Patients may not feel ATP at all, although some may notice palpitations.

Cardioversion or Defibrillation Shock

If the rhythm is very fast, unstable or does not respond to ATP, the ICD may deliver a higher-energy electrical shock.

The shock passes through the heart and can terminate ventricular tachycardia or ventricular fibrillation. Unlike pacing therapy, a conscious patient may feel a shock as a sudden, forceful impact in the chest.

Backup Pacemaker Function

Many transvenous ICDs can also provide pacing if the heart rate becomes too slow. This can be particularly relevant in cardiac amyloidosis because conduction-system disease and bradyarrhythmias may coexist with ventricular arrhythmias.

Nevertheless, device selection should account for the patient’s entire electrical phenotype rather than assuming that every patient requires the same type of ICD system.

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Figure 1. How an Implantable Cardioverter-Defibrillator Works. A transvenous ICD continuously senses the heart rhythm through an intracardiac lead. When a programmed ventricular tachyarrhythmia is detected, the device may deliver antitachycardia pacing or an electrical shock to restore a safer rhythm. Many ICD systems can also provide backup pacing for slow heart rhythms.

Why Are Ventricular Arrhythmias Important in Cardiac Amyloidosis?

Amyloid fibrils deposited within the myocardium can alter cardiac structure, electrical conduction and repolarization. As a result, patients with cardiac amyloidosis can develop both slow and fast rhythm disturbances.

Ventricular arrhythmias include premature ventricular complexes, nonsustained ventricular tachycardia, sustained ventricular tachycardia and ventricular fibrillation. Nonsustained ventricular arrhythmias are frequently detected in both AL and ATTR cardiac amyloidosis, although their ability to predict future sudden cardiac death remains uncertain (1).

Importantly, the mechanisms of sudden death in cardiac amyloidosis are heterogeneous. A patient may experience a shockable ventricular tachyarrhythmia, but death can also occur from progressive heart failure, profound bradyarrhythmia or pulseless electrical activity/electromechanical dissociation.

This distinction explains why appropriate ICD shocks can occur without necessarily translating into improved overall survival in observational studies.

Who May Be Considered for an ICD?

The decision begins with the same broad distinction used in other cardiomyopathies: secondary prevention versus primary prevention.

Clinical Situation	Meaning	Consideration in Cardiac Amyloidosis
Secondary prevention	Previous sustained ventricular tachycardia, ventricular fibrillation or resuscitated cardiac arrest when a reversible cause has been excluded	Generally provides a stronger rationale for ICD consideration if the patient has an acceptable overall prognosis and expected benefit
Primary prevention	No previous sustained life-threatening ventricular arrhythmia, but concern about future sudden arrhythmic death	More controversial because amyloidosis-specific survival benefit has not been convincingly demonstrated
Nonsustained VT alone	Short episodes of ventricular tachycardia that terminate spontaneously	May contribute to risk assessment but does not by itself establish that ICD implantation will improve survival
Advanced end-stage disease	Severe multisystem amyloidosis or advanced heart failure with limited expected survival	Competing non-arrhythmic mortality may substantially reduce potential ICD benefit

Secondary Prevention: When the Rationale Is Stronger

Secondary-prevention ICD therapy refers to implantation after a patient has already experienced a serious ventricular arrhythmia or resuscitated cardiac arrest, provided that the event was not caused by a clearly reversible factor.

In conventional cardiovascular practice, this represents one of the strongest indications for ICD therapy. The same principle can apply to selected patients with cardiac amyloidosis.

However, even in secondary prevention, clinicians must assess the broader clinical picture. The potential benefit becomes less certain when the patient has advanced irreversible heart failure, severe extracardiac disease, profound frailty or another condition likely to limit meaningful survival.

The decision should therefore combine arrhythmic history with amyloidosis stage and overall prognosis rather than focusing only on the previous ventricular arrhythmia.

Primary Prevention Is More Uncertain

Primary-prevention ICD implantation aims to prevent sudden arrhythmic death before a patient has experienced a sustained ventricular tachyarrhythmia or cardiac arrest.

In many forms of systolic heart failure, ICDs have established guideline-based primary-prevention indications. Cardiac amyloidosis is different because many patients have severe cardiac disease despite a relatively preserved left ventricular ejection fraction, and sudden death may occur through mechanisms that are not treatable by an ICD.

The 2023 ACC Expert Consensus Decision Pathway states that there is insufficient evidence to recommend amyloidosis-specific primary-prevention ICD implantation beyond standard indications. Instead, individualized decision-making is recommended (1).

Important: Cardiac amyloidosis, increased wall thickness, elevated biomarkers or nonsustained ventricular tachycardia should not automatically be interpreted as an indication for prophylactic ICD implantation.

What Have Studies of ICDs in Cardiac Amyloidosis Shown?

Published evidence consists largely of retrospective cohorts and observational studies rather than randomized trials.

In a Mayo Clinic study of 53 patients with cardiac amyloidosis who received an ICD, appropriate shocks occurred in approximately one-third of patients during the first year and were particularly frequent among patients with AL amyloidosis. However, the investigators did not demonstrate an overall survival advantage from ICD therapy (3).

Another study of patients with severe cardiac amyloidosis found that ICDs successfully treated ventricular tachyarrhythmias in some individuals. Nevertheless, many deaths resulted from electromechanical dissociation, which cannot be treated by defibrillation (4).

Hamon and colleagues similarly documented appropriate ICD therapies in selected patients but emphasized the difficulty of predicting which patients would derive meaningful long-term benefit (5).

A large registry analysis later showed that mortality after ICD implantation remained substantially higher in patients with amyloid cardiomyopathy than in propensity-matched patients with other nonischemic cardiomyopathies (6).

Together, these studies explain why current expert guidance remains cautious: an ICD may successfully terminate ventricular arrhythmias, yet successful shocks do not automatically establish an overall survival benefit.

How Is a Patient Evaluated Before ICD Implantation?

Evaluation should define both the arrhythmic indication and the patient’s overall likelihood of benefiting from the device.

The assessment may include:

12-lead ECG;
ambulatory rhythm monitoring;
documentation of nonsustained or sustained ventricular tachycardia;
history of cardiac arrest, syncope or presyncope;
echocardiography;
left and right ventricular function;
cardiac MRI where clinically appropriate;
heart-failure severity;
amyloid subtype and disease stage;
renal and other extracardiac organ involvement;
frailty and nutritional status;
expected survival and competing causes of death; and
patient preferences and goals of care.

The team should also confirm that the underlying amyloid diagnosis has been established correctly. Diagnostic evaluation may include monoclonal protein testing, bone scintigraphy, genetic testing and, when necessary, biopsy with amyloid typing.

How Is an ICD Implanted?

Most conventional ICDs are implanted through a transvenous procedure rather than open-heart surgery. The procedure is usually performed in an electrophysiology or cardiac catheterization laboratory using sterile technique, imaging guidance and continuous monitoring.

1. Preparation and Monitoring

Before implantation, the clinical team reviews the indication, medications, anticoagulation strategy, allergies, kidney function and relevant laboratory results. An ECG and cardiac imaging are commonly available as part of the pre-procedure assessment.

During the procedure, the patient receives continuous ECG, blood-pressure and oxygen monitoring. Local anesthesia is used at the implant site, and sedation or anesthesia is provided according to the patient’s clinical condition and institutional practice.

2. Creating the Device Pocket

The operator makes a small incision in the upper chest, usually below the collarbone.

A pocket is created beneath the skin or deeper tissues to hold the pulse generator. The exact position depends on anatomy, device type and procedural approach.

3. Obtaining Venous Access

For a transvenous ICD, the operator obtains access to a vein in the upper chest region. A guidewire and introducer system allow the ICD lead to be advanced through the venous circulation toward the heart.

4. Positioning the ICD Lead

Under fluoroscopic guidance, the lead is advanced into the right ventricle. The distal portion of an ICD lead contains sensing and pacing electrodes as well as one or more shock coils.

The operator confirms that the lead position provides acceptable electrical sensing and pacing characteristics and that the lead is mechanically stable.

5. Connecting the Generator

After satisfactory lead positioning, the lead is connected to the ICD pulse generator.

The generator is then placed into the prepared pocket beneath the skin. The device contains the battery, capacitors and electronic circuitry responsible for detecting arrhythmias and delivering therapy.

6. Testing and Programming

The implanted system is electronically tested before completion of the procedure. The electrophysiology team programs detection thresholds, pacing settings and treatment zones according to the patient’s rhythm history and clinical requirements.

Whether formal defibrillation-threshold testing is performed depends on the device, patient characteristics, procedural approach and contemporary electrophysiology practice.

7. Closing the Incision

Once the device and lead are confirmed to be functioning appropriately, the incision is closed using sutures, surgical adhesive or another closure technique.

A dressing is placed over the wound, and the patient is transferred to a recovery area for monitoring.

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Figure 2. ICD Implantation Procedure. During transvenous ICD implantation, venous access is obtained near the upper chest and an ICD lead is advanced into the right ventricle. The lead is connected to a pulse generator placed beneath the skin. The system is then tested, programmed and the incision closed.

What Is the Difference Between a Transvenous ICD and a Subcutaneous ICD?

Not every ICD system uses an intracardiac lead. Two major configurations are relevant.

Feature	Transvenous ICD	Subcutaneous ICD
Lead position	Lead passes through a vein into the heart	Electrode remains beneath the skin along the chest wall/sternum
Defibrillation	Yes	Yes
Antitachycardia pacing	Usually available	Not available with conventional S-ICD systems
Chronic bradycardia pacing	Available depending on device configuration	Not a chronic pacing solution
Transvenous lead complications	Possible	Avoided because no lead is placed inside the heart
Potential relevance in amyloidosis	May be preferable if pacing is or may become necessary	May be considered when defibrillation is needed but permanent pacing is not expected

This distinction can be particularly relevant in cardiac amyloidosis because conduction disease may progress over time. Patients who are likely to develop a significant pacing requirement may not be ideal candidates for a system that cannot provide chronic pacing.

Therefore, electrophysiologists should consider not only today’s arrhythmic problem but also the likely evolution of conduction disease.

What Happens Immediately After ICD Implantation?

After implantation, the patient is monitored for procedure-related complications and the device is interrogated to confirm appropriate function.

Depending on local practice and the patient’s condition, evaluation may include:

inspection of the device pocket;
device interrogation;
assessment of lead sensing and pacing parameters;
ECG monitoring;
chest imaging when clinically indicated;
pain assessment;
review of anticoagulation or antithrombotic therapy; and
instructions for wound care and activity.

Many patients can leave hospital within a short period after uncomplicated implantation, although patients with advanced cardiac amyloidosis or significant comorbidities may require longer observation.

Recovery After ICD Implantation

The incision may remain tender or swollen for several days. Patients receive individualized instructions on wound care, bathing, driving and physical activity.

Movements that place excessive strain on the implant side may be temporarily restricted while the wound heals and the lead becomes more securely incorporated into tissue.

Patients should contact their clinical team if they develop increasing redness, swelling, drainage, fever, severe pain or other concerning symptoms around the device pocket.

What Are the Risks of ICD Implantation?

ICD implantation is a commonly performed cardiac procedure, but complications can occur.

Potential procedural and long-term risks include:

bleeding or pocket hematoma;
infection;
pneumothorax;
blood-vessel injury;
cardiac perforation or pericardial effusion;
lead displacement;
lead malfunction or fracture;
device-pocket problems;
inappropriate shocks;
need for future lead revision or extraction; and
future generator replacement when the battery approaches depletion.

The individual risk depends on age, anatomy, comorbidities, anticoagulation, device configuration and operator experience.

What Is an Inappropriate ICD Shock?

An inappropriate shock occurs when the ICD delivers high-energy therapy even though the patient does not have a ventricular arrhythmia that requires defibrillation.

Potential causes include rapid atrial fibrillation, other supraventricular tachycardias, oversensing or lead problems.

Modern programming strategies can reduce unnecessary shocks by allowing longer detection times, using appropriate rate thresholds and applying ATP before shock therapy when suitable.

Patients who experience an ICD shock should follow the action plan provided by their electrophysiology team. Multiple shocks, persistent symptoms, syncope, chest pain or severe breathlessness require urgent medical assessment.

Why Can an ICD Fail to Prevent Sudden Death in Amyloidosis?

This is one of the most important concepts in understanding ICD therapy in cardiac amyloidosis.

An ICD is highly specialized: it treats certain electrical rhythms. It cannot restore effective circulation when the myocardium is too severely diseased to contract adequately despite continued electrical activity.

In advanced amyloid cardiomyopathy, sudden death may occur through electromechanical dissociation or pulseless electrical activity. In this situation, the electrical rhythm may persist, but the heart fails to generate an effective pulse.

Because there may be no shockable ventricular tachyarrhythmia, an ICD cannot prevent this type of death.

This competing mechanism is an important reason why appropriate ICD therapies have been documented in amyloidosis while an overall survival benefit has remained difficult to demonstrate (3, 4, 5).

Does Low Ejection Fraction Automatically Mean an ICD Is Needed?

No. Left ventricular ejection fraction remains important in standard heart-failure ICD guidelines, but cardiac amyloidosis requires additional interpretation.

Amyloid cardiomyopathy often causes severe restrictive physiology and substantial clinical risk before the ejection fraction becomes markedly reduced.

Conversely, a reduced ejection fraction in very advanced amyloidosis may identify a patient with a high competing risk of progressive pump failure rather than predominantly shockable ventricular arrhythmic death.

Therefore, ejection fraction should be interpreted together with arrhythmia history, disease stage, functional status, extracardiac disease and expected survival.

Does Nonsustained VT Mean a Patient Needs an ICD?

Not necessarily.

Nonsustained ventricular tachycardia is relatively common in cardiac amyloidosis. However, current expert guidance notes that it remains unclear whether nonsustained ventricular arrhythmias reliably predict subsequent sudden cardiac death (1).

Its presence may contribute to an electrophysiological risk assessment, particularly when combined with syncope or other concerning findings, but it should not be used in isolation as an automatic trigger for ICD implantation.

How Does Amyloid Type Affect the Decision?

The two major forms of cardiac amyloidosis have different biology and clinical trajectories.

In AL amyloidosis, rapid control of the underlying plasma-cell disorder is central because circulating amyloidogenic light chains can cause aggressive multisystem disease.

In ATTR-CM, the disease may occur as hereditary ATTR or wild-type ATTR.

Some older observational ICD studies reported relatively frequent appropriate shocks among patients with AL amyloidosis. However, this finding does not establish that all patients with AL disease benefit from prophylactic ICD implantation, because competing mortality from progressive amyloidosis remains substantial (3).

Accurate amyloid typing and effective disease-specific therapy therefore remain fundamental parts of the decision.

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Figure 3. When Is an ICD Considered in Cardiac Amyloidosis? ICD assessment begins with the patient’s arrhythmic history and conventional device indications. Previous sustained ventricular tachycardia, ventricular fibrillation or resuscitated cardiac arrest can provide a stronger secondary-prevention rationale. Primary-prevention decisions are more uncertain and require assessment of heart-failure stage, extracardiac disease, competing causes of death, expected survival and patient preferences.

ICD Therapy Does Not Replace Amyloidosis Treatment

Even a perfectly functioning ICD does not stop amyloid production or reverse amyloid already deposited within the heart.

Patients therefore continue to require appropriate cardiac amyloidosis treatment.

For ATTR-CM, disease-modifying treatment targets the transthyretin disease process. For AL amyloidosis, therapy targets the abnormal hematologic clone responsible for producing amyloidogenic light chains.

Heart-failure management, arrhythmia treatment, anticoagulation when indicated and management of extracardiac disease remain necessary alongside ICD follow-up.

Follow-Up After ICD Implantation

ICDs require lifelong surveillance. Follow-up may occur through in-person device interrogation, remote monitoring or both.

Clinicians assess:

battery status;
lead integrity;
sensing and pacing thresholds;
percentage of ventricular pacing;
recorded episodes of ventricular tachycardia or fibrillation;
ATP therapies;
appropriate and inappropriate shocks;
atrial arrhythmias;
heart-failure progression; and
changes in the patient’s overall amyloidosis status.

Device data can provide valuable information about the evolution of conduction disease and arrhythmia burden in cardiac amyloidosis (7).

What Happens If Cardiac Amyloidosis Progresses?

An ICD cannot reverse progressive restrictive cardiomyopathy. Therefore, worsening heart failure despite disease-specific treatment and appropriate device therapy should prompt reassessment of the overall management plan.

Selected patients with advanced disease may require evaluation for heart transplantation in cardiac amyloidosis.

However, transplantation requires careful evaluation of amyloid type, extracardiac disease, control of the underlying amyloid process, functional status and expected post-transplant benefit.

ICD Implantation and Cardiac Amyloidosis in Africa

The ability to implant an ICD is only one component of effective device therapy. Sustainable programs require electrophysiology expertise, appropriate patient selection, sterile procedural facilities, fluoroscopy, device programming, emergency support and reliable long-term follow-up.

Across African health systems, access to ICD implantation and specialist electrophysiology services varies considerably. Patients may also face barriers related to device cost, travel, follow-up, generator replacement and remote-monitoring infrastructure.

At the same time, ICD access should not be separated from improving the underlying diagnostic pathway. Patients first need accurate recognition of cardiac amyloidosis in Africa, appropriate amyloid typing and access to disease-specific treatment.

More African data are also needed. Existing ICD evidence in cardiac amyloidosis largely reflects North American and European cohorts. Multicountry registries can help characterize ventricular arrhythmias, sudden-death mechanisms, device utilization and outcomes in African patients.

Africa-focused priority: Expanding ICD access should be accompanied by stronger cardiac amyloidosis diagnostic pathways, electrophysiology capacity, device follow-up systems and access to disease-modifying therapy.

Key Takeaways

An ICD continuously monitors the heart and can treat selected dangerous ventricular tachyarrhythmias.
A transvenous ICD usually consists of a pulse generator implanted beneath the upper-chest skin and one or more leads positioned through a vein into the heart.
The device may deliver antitachycardia pacing or a higher-energy shock depending on the rhythm and programming.
Secondary-prevention ICD therapy has a stronger rationale after sustained ventricular tachycardia, ventricular fibrillation or resuscitated cardiac arrest in an otherwise appropriate candidate.
Primary-prevention ICD therapy in cardiac amyloidosis remains controversial because amyloidosis-specific studies have not convincingly demonstrated an overall survival benefit.
Sudden death in advanced cardiac amyloidosis can result from electromechanical dissociation or pump failure, which an ICD cannot treat.
Nonsustained ventricular tachycardia alone does not automatically mean that an ICD should be implanted.
Patient selection should consider arrhythmic history, heart-failure stage, amyloid type, extracardiac disease, frailty, expected survival and patient preferences.
An ICD does not treat the underlying amyloidosis. Disease-specific therapy remains essential.
Long-term device interrogation and amyloidosis follow-up are required after implantation.

Frequently Asked Questions

Is an ICD the Same as a Pacemaker?

No. A pacemaker primarily treats clinically important slow heart rhythms. An ICD is designed to detect and treat potentially life-threatening ventricular tachyarrhythmias. However, many transvenous ICDs also contain pacemaker functions.

Does Every Patient With Cardiac Amyloidosis Need an ICD?

No. Cardiac amyloidosis alone is not an indication for ICD implantation. The decision depends on conventional ICD indications, arrhythmic history, disease stage and expected benefit.

Can an ICD Stop Ventricular Tachycardia?

Yes. Depending on the rhythm and programming, an ICD may terminate ventricular tachycardia using antitachycardia pacing or an electrical shock.

Can an ICD Stop Ventricular Fibrillation?

An ICD can detect ventricular fibrillation and deliver a defibrillation shock intended to restore an organized rhythm. This is one of its principal lifesaving functions.

Can an ICD Prevent All Sudden Death in Cardiac Amyloidosis?

No. An ICD treats certain ventricular electrical arrhythmias. It cannot correct sudden death caused by severe pump failure or electromechanical dissociation.

Does Nonsustained Ventricular Tachycardia Mean I Need an ICD?

Not necessarily. Nonsustained VT may contribute to risk assessment, but current evidence does not show that it should automatically lead to ICD implantation in cardiac amyloidosis.

How Long Does ICD Implantation Take?

A conventional transvenous ICD implantation commonly takes a few hours, although the duration varies according to anatomy, device type, number of leads and procedural complexity.

Can an ICD Deliver a Shock While a Person Is Awake?

Yes. If a serious ventricular arrhythmia occurs while the patient is conscious, a high-energy ICD shock may be felt. Many patients describe it as a sudden strong impact that lasts only briefly.

Does ICD Implantation Cure Cardiac Amyloidosis?

No. The ICD treats arrhythmic complications only. Patients still require treatment directed at the underlying AL or ATTR amyloidosis and appropriate management of heart failure and other organ involvement.

References

Kittleson MM, Ruberg FL, Ambardekar AV, et al. 2023 ACC Expert Consensus Decision Pathway on Comprehensive Multidisciplinary Care for the Patient With Cardiac Amyloidosis. J Am Coll Cardiol. 2023;81(11):1076–1126. doi:10.1016/j.jacc.2022.11.022.
Garcia-Pavia P, Rapezzi C, Adler Y, et al. Diagnosis and treatment of cardiac amyloidosis: a position statement of the ESC Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2021;42(16):1554–1568. doi:10.1093/eurheartj/ehab072.
Lin G, Dispenzieri A, Kyle R, Grogan M, Brady PA. Implantable cardioverter defibrillators in patients with cardiac amyloidosis. J Cardiovasc Electrophysiol. 2013;24(7):793–798. doi:10.1111/jce.12123.
Kristen AV, Dengler TJ, Hegenbart U, et al. Prophylactic implantation of cardioverter-defibrillator in patients with severe cardiac amyloidosis and high risk for sudden cardiac death. Heart Rhythm. 2008;5(2):235–240. doi:10.1016/j.hrthm.2007.10.016.
Hamon D, Algalarrondo V, Gandjbakhch E, et al. Outcome and incidence of appropriate implantable cardioverter-defibrillator therapy in patients with cardiac amyloidosis. Int J Cardiol. 2016;222:562–568. doi:10.1016/j.ijcard.2016.07.254.
Higgins AY, Annapureddy AR, Wang Y, et al. Survival following implantable cardioverter-defibrillator implantation in patients with amyloid cardiomyopathy. J Am Heart Assoc. 2020;9:e016038.
Rehorn MR, Loungani RS, Black-Maier E, et al. Cardiac implantable electronic devices: a window into the evolution of conduction disease in cardiac amyloidosis. JACC Clin Electrophysiol. 2020;6(9):1144–1154. doi:10.1016/j.jacep.2020.04.020.
Varr BC, Zarafshar S, Coakley T, et al. Implantable cardioverter-defibrillator placement in patients with cardiac amyloidosis. Heart Rhythm. 2014;11(1):158–162. doi:10.1016/j.hrthm.2013.10.026.

Medical Disclaimer

This article provides general educational information and does not replace individualized medical advice, diagnosis or treatment. Decisions regarding ICD implantation should be made by qualified cardiology and electrophysiology professionals after assessment of the individual patient’s ventricular arrhythmias, cardiac function, amyloid type, disease stage, comorbidities, prognosis and preferences.

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