Extravascular implantable cardioverter defibrillator insertion for preventing sudden cardiac death

Status:

In progress

Technology type:

Procedure

Decision:

Selected

Reason for decision:

Anticipate the topic will be of importance to patients, carers, professionals, commissioners and the health of the public to ensure clinical benefit is realised, inequalities in use addressed, and help them make the best use of NHS resources

Process:

IP

ID number:

2064

Description:

Sudden cardiac death is commonly caused by ventricular arrhythmias, which may be an abnormally fast heartbeat (ventricular tachycardia) or an irregular rhythm (ventricular fibrillation). The most common cause of ventricular arrhythmias is underlying heart disease. An implantable cardioverter defibrillator (ICD) is a device that senses for a dangerous arrhythmia and if necessary, delivers a small electric shock to return the heartbeat to its normal rhythm. A conventional transvenous ICD system has a defibrillator that is implanted on the left side of the chest wall with 1 or more leads that pass through a vein into the heart. With an extravascular ICD, the defibrillator is implanted below the left armpit and the lead is placed beneath the breastbone, outside of the heart and veins. If a dangerous arrhythmia is detected, the extravascular ICD will first send small electrical signals to correct the heart rate (anti-tachycardia pacing). If the arrhythmia continues, the defibrillator sends an electric shock to reset it back to normal (cardioversion or defibrillation). The extravascular ICD can also treat slow heart rhythms by sending a short series of electrical pulses to help the heart resume a normal rhythm. An extravascular ICD aims to prevent sudden cardiac death in people who are known to be at risk.

Provisional Schedule

Draft scope consultation:

26 March 2026 - 10 April 2026

Final scope:

08 May 2026

Email enquiries

If you have any queries please email IP@nice.org.uk

Timeline

Key events during the development of the guidance:

For further information on how we develop interventional procedures guidance, please see our interventional procedures programme manual