Sudden Death Prevention in Heart Failure: What Role for ICD?
Heart failure is one of the most frequent cardiovascular diseases, with a high cost to health care; in Italy about 1 million people are estimated to suffer from heart failure. The annual mortality due to heart failure ranges from 16% to 30%, increasing to 70% when patients with severe symptoms are considered. The relative rates of sudden death decrease with increase in NYHA class . In 70%-80% of patients sudden death is due to an arrhythmia such as monomorphic ventricular tachycardia, polymorphic ventricular tachycardia, ventricular fibrillation, or in 15%-20%, bradyarrhythmias.
KeywordsSudden Death Sudden Cardiac Death Left Ventricular Dysfunction Implantable Defibrillator Antiarrhythmic Versus Implantable Defibrillator
Unable to display preview. Download preview PDF.
- 7.GISSI Prevenzione Investigators (1999) Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSIPrevenzione trial. Lancet 354:447–455Google Scholar
- 10.Packer M, Bristow MR, Cohn JN et al, for the US Carvedilol Heart Failure Study Group (1996) The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. N Engl J Med 334:1349–1355Google Scholar
- 14.Waldo AL, Camm AJ, deRuyter H et al, for the SWORD investigators (1996) Effect of D-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. 348:7–12Google Scholar
- 15.Torp-Pedersen C, Moller M, Bloch-Thomsen PE et al, for the Danish Investigations of Arrhythmia and Mortality on Dofetilide Study Group (1999) Dofetilide in patients with congestive heart failure and left ventricular dysfunction. N Engl J Med 341:857–865Google Scholar
- 16.Kober L, Bloch-Thomsen PE, Moller M et al, on behalf of the Danish Investigations of Arrhythmia and Mortality on Dofetilide (DIAMOND) Study Group (2000) Effect of dofetilide in patients with recent myocardial infarction and left-ventricular dysfunction: a randomised trial. Lancet 356:2052–2058Google Scholar
- 17.The Antiarrhythmics versus Implantable Defibrillator (AVID) Investigators (1997) A comparison of antiarhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. N Engl J Med 337:1761583Google Scholar
- 18.Connoly SJ, Gent M, Roberts RS et al, for the CIDS investigators (2000) Canadian Implantable Defibrillator Study (CIDS). A randomized trial of the implantable cardioverter defibrillator against amiodarone. Circulation 101:1297–1302Google Scholar
- 20.Cappato R (1999) Secondary prevention of sudden death: the Dutch Study, the Antiarrhythmics Versus Implantable Defibrillator Trial, the Cardiac Arrest Study Hamburg, and the Canadian Implantable Defibrillator Study. Am J Cardiol 83:68D–73DGoogle Scholar
- 21.Domanski MJ, Sakseena S, Epstein AE et al, for the AVID investigators (1999) Relative effectiveness of the implantable cardioverter-defibrillator and antiarrhythmic drugs in patients with varying degrees of left ventricular dysfunction who have survived malignant ventricular arrhythmias. J Am Coll Cardiol 34:1090–1095Google Scholar
- 22.Moss AJ, Hall WJ, Cannom DS et al, for the MADIT investigators (1996) Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. N Engl J Med 335:1933–1940Google Scholar
- 23.Buxton AE, Lee KL, Fisher JD et al, for the MUSTT (1999) A randomized study of the prevention of sudden death in patients with coronary artery disease. N Engl J Med 341:1882–1890Google Scholar
- 26.Moss AJ, Zareba W, Hall WJ et al, for the MADIT II Investigators (2001) Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med 346:877–883Google Scholar