The defibrillation conundrum: new insights into the mechanisms of shock-related myocardial injury sustained from a life-saving therapy - Archive ouverte HAL Access content directly
Journal Articles (Review Article) International Journal of Molecular Sciences Year : 2021

The defibrillation conundrum: new insights into the mechanisms of shock-related myocardial injury sustained from a life-saving therapy

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Abstract

Implantable cardiac defibrillators (ICDs) are recommended to prevent the risk of sudden cardiac death. However, shocks are associated with an increased mortality with a dose response effect, and a strategy of reducing electrical therapy burden improves the prognosis of implanted patients. We review the mechanisms of defibrillation and its consequences, including cell damage, metabolic remodeling, calcium metabolism anomalies, and inflammatory and pro-fibrotic remodeling. Electrical shocks do save lives, but also promote myocardial stunning, heart failure, and pro-arrhythmic effects as seen in electrical storms. Limiting unnecessary implantations and therapies and proposing new methods of defibrillation in the future are recommended.
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hal-03741929 , version 1 (02-08-2022)

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Attribution - CC BY 4.0

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Nicolas Clementy, Alexandre Bodin, Arnaud Bisson, Ana-Paula Teixeira-Gomes, Sebastien Roger, et al.. The defibrillation conundrum: new insights into the mechanisms of shock-related myocardial injury sustained from a life-saving therapy. International Journal of Molecular Sciences, 2021, 22 (9), pp.1-17. ⟨10.3390/ijms22095003⟩. ⟨hal-03741929⟩
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