NICE consults on draft updated recommendations on implantable devices for the treatment of life-threatening arrhythmias and heart failure


The UK’s National Institute for Health and Care Excellence (NICE) has published a draft guidance update of existing NICE guidelines on the use of implantable cardioverter defibrillators (ICDs) in people with ventricular arrhythmias and cardiac resynchronisation therapy for people with heart failure.

The draft guidance defines which implantable cardiac devices are clinically and cost effective options for people with life-threatening arrhythmias or heart failure.

“The Committee heard that patients who survive a cardiac arrest, or who have a higher risk of sudden death due to ventricular arrhythmia, live in constant fear of death. Antiarrhythmic drugs are often not effective, can have unpleasant side-effects and sometimes need frequent dose adjustments which can be demanding for patients and lead to missing doses, taking the wrong dose or overdose. Heart failure, particularly of the severity covered by this guidance, can be both distressing and have a significant negative impact on a person’s quality of life. Implantable devices therefore represent an important option for both the treatment and prevention of potentially life threatening arrhythmias and heart failure,” says Carole Longson, NICE Health Technology Evaluation Centre director.

He continues, “The recommendations in our original guidance on ICDs for people who have survived an episode of ventricular tachycardia or ventricular fibrillation and for people with specific cardiac conditions did not need to be updated, as there was no new evidence. Therefore the updated recommendations in this draft guidance, which are based on a new, and comprehensive analysis of all major clinical trials, relate only to people at risk of sudden cardiac death because of heart failure. As a result we have been able to clearly define which of the different devices is a clinically and cost effective treatment option for people who are at risk of sudden cardiac death because of left ventricular dysfunction. We welcome comments on these draft recommendations as part of the consultation.”

The draft recommendations are available here.