Do implantable cardioverter-defibrillators benefit patients immediately after acute myocardial infarction?

Anne B Curtis

This article has no abstract so we have provided the first paragraph of the full text.

ICDs improve survival in patients who have survived an episode of life-threatening ventricular arrhythmia, as demonstrated by the Antiarrhythmics Versus Implantable Defibrillators (AVID) trial.¹ Most patients do not survive cardiac arrest and benefit from subsequent ICD implantation, so there has been great interest in exploring the benefits of prophylactic ICD implantation. Most of the clinical trials in this area have included patients with ischemic heart disease and have shown a benefit after ICD implantation. The Multicenter Automatic Defibrillator Implantation Trials (MADIT) I and II^{2, 3} and the Multicenter UnSustained Tachycardia Trial (MUSTT)⁴ enrolled patients in whom MI had caused varying degrees of left-ventricular dysfunction—the upper limit of ejection fraction was 30–40%—with and without the use of an electrophysiologic study for risk stratification. The recently completed Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), which included patients with both ischemic and nonischemic cardiomyopathies, also showed that ICD implantation in patients with left-ventricular dysfunction—an ejection fraction of 35% or less—and heart failure conferred a survival benefit.⁵

ARTICLE NAVIGATION - ARTICLE TOOLS

• Full text
• Download PDF
• Send to a friend
• PDA services
• Permissions
• Rights and permissions
• Order commercial reprints

ISSUE NAVIGATION - THIS ISSUE

• Table of Contents
• Previous article
• Next article