“Hosting” an implantable cardioverter defibrillator: A phenomenological inquiry

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Sudden cardiac death (SCD) is one of the leading causes of death in all industrialized countries, with a survival index below 5% in Western Europe. Nearly 80% of these deaths are caused by malignant ventricular tachyarrhythmia, such as ventricular tachycardia or ventricular fibrillation induced by intense ischemic events, in particular as a consequence of myocardial infarction (Arzamendi et al., 2011; Ladich, Virmani, & Burke, 2006). Implantable cardioverter defibrillators (ICDs) are heart monitors that are placed under the skin. These devices are capable of generating electrical pulses to stimulate and regulate the heartbeat through anti‐bradycardic and anti‐tachycardic impulses.
ICDs have contributed to decreased mortality among patients at risk of SCD (Zipes et al., 2006). Recent reviewers showed that ICDs should be considered the best first‐ and second‐line prevention in patients at risk of SCD, as well as in patients with familial or inherited conditions like long QT syndrome, hypertrophic cardiomyopathy, arrhythmogenic right ventricular cardiomyopathy, or Brugada syndrome (Brugada & Benito, 2009; Brugada & Brugada, 1992; Gupta, Al‐Ahmad, & Wang, 2011; Health Quality Ontario, 2005; Uhlig et al., 2013). The Brugada syndrome (BS), in particular, is an inherited condition that was first described in 1992 as a right bundle branch block and persistent ST segment elevation causing unexpected SCD in young subjects. The original description of the syndrome, based on eight patients (Brugada & Benito, 2009), was followed by a number of publications in the last 25 years that defined the genetic, molecular, and cellular aspects of this disease. BS is thought to be responsible for 4–12% of all SCD and for 20–50% of SCD in subjects without structural cardiopathy (Brugada & Benito, 2009). Patients receiving an ICD are a heterogeneous population in terms of underlying medical conditions and age, furthermore, as the indications for ICD implantation have been gradually extended over the last few years, the number of ICD recipients will likely continue to increase (Dickstein et al., 2008).
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