2026, Number 3
Cardiovasc Metab Sci 2026; 37 (3)
Should the battery of the implantable cardioverter defibrillator be changed or not, due to depletion and the fact that it has never been discharged?
Álvarez de la Cadena-Sillas, Jorge; Asensio-Lafuente, Enrique; Aguilar-Linares, Julio; Jiménez-Cruz, Marcelo
ABSTRACT
The use of Implantable Cardioverter Defibrillators (ICDs) has proven to be effective and useful to improve survival rates after Sudden Cardiac Death (SCD) in patients with clinical indications for their use. However, replacing a generator that has never administered electrical therapies and now shows battery depletion can generate controversy. In this paper, we analyze different factors that must be considered prior to the generator’s replacement in this subset of patients. The main points are improvement or not of the Left Ventricular Ejection Fraction (LVEF), risk re-stratification at the time of replacement, the presence or absence of inappropriate ICD therapies, the severity of the heart disease, the prognosis at the time of the substitution, present comorbidities, life expectancy and advancing age, the possible complications of the new procedure, the possibility of de-escalating the device, financial factors, as well as the patient’s own decision and the underlying clinical discussion.