The role of prophylactic implantable cardioverter defibrillators in heart failure: Recent trials usher in a new era of device therapy |
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Authors: | Timothy D Brennan Garrie J Haas |
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Institution: | (1) Department of Internal Medicine, Division of Cardiovascular Medicine, The Ohio State University Medical Center, 43210 Columbus, OH, USA |
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Abstract: | Sudden cardiac death (SCD) manifested as ventricular fibrillation or sustained ventricular tachycardia has been a major focus
of cardiovascular research for more than three decades. Although mortality in patients with heart failure (HF) caused by left
ventricular systolic dysfunction has declined in recent years through effective pharmacotherapeutic strategies, SCD remains
the major cause of death in symptomatic HF, with little improvement by drug therapy. Although it is clear that the implantable
cardioverter defibrillator (ICD) is efficacious and should be used to prevent a recurrence of sustained ventricular arrhythmia
(secondary prevention) in most patients, the guidelines for prophylactic use of ICDs (primary prevention) are less well defined.
The results of recent clinical trials examining the efficacy of prophylactic ICD therapy in HF patients have clarified the
role of ICD treatment in this population. This article reviews these trials and summarizes our current approach to the prevention
of SCD in HF. |
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