[rdmirza]

Even better is installing an implantable cardiac defibrillator (ICD) in those at high risk.

[noughtme]

> at high risk.

Before an event? I’m not sure what insurance would cover this. I don’t really want open heart surgery before I need it.

[Calavar]

Plenty of insurance plans cover ICD implantation because it is recommended by the American College of Cardiology for specific situations:

1. moderately to severely reduced systolic function of the heart due to a heart attack that persists > 40 days after the heart attack

2. severely reduced systolic function of the heart of any cause that does not improve after 3 to 6 months of pharmacologic therapy

3. personal history of sudden cardiac death with a persistent risk factor

ICD implantation is not open heart surgery. It is a relatively quick procedure that is done by a cardiologist rather than a cardiothoracic surgeon.

[plugin-baby]

> personal history of sudden cardiac death with a persistent risk factor

Personal history, or family history? Maybe this is a technical term? As a non-medic I can’t imagine there are many people who have a history of sudden death AND a persistent risk of it happening again.

[Calavar]

Personal history.

"Many" is relative. We are talking about a fraction of a percent of the general population, but if you are looking specifically at the population of people who have some form of long standing heart disease, it's not terribly rare. I don't work in cardiology specifically, and even so I encounter one or two patients a year who have had an ICD placed for reason #3.

Persistent risk factors include things like or overgrowth of muscular heart tissue (which has dozens of causes, but the most common is severe, long standing coronary artery disease) or scarring of the heart after a heart attack.

Persistent risk factors are not rare at all. The thing is that most people who fall into bucket 3 also fall into buckets 1 or 2. So in an ideal world they would have already seen a cardiologist and had an ICD placed before they ever had an episode of SCD. And of course many of those who do have SCD don't survive long enough to have an ICD placed.

If you are interested in reading more, you can search for "secondary prevention of sudden cardiac death" or "secondary prophylaxis of sudden cardisc death." There are some good review articles available online.