ICDs Beneficial in a More Easily Identifiable Population

These researchers used simple clinical criteria to identify heart patients who would benefit from defibrillator therapy.

Implantable cardioverter-defibrillators (ICDs) prolong survival in patients with ischemic cardiomyopathy and a positive electrophysiology study (Journal Watch Cardiology Jan 21 2000). The MADIT II trial was designed to determine whether ICDs prolong survival in a more easily identifiable population: patients with prior MI and LV ejection fractions of ≤30%. A total of 1232 such patients were randomized in a 3:2 ratio to either ICD implantation or conventional medical therapy; mean follow-up was 20 months. Demographic features of the 2 groups were similar: For example, 70% of both received concomitant beta-blocker therapy; both had mean LVEFs of 23%.

The mortality rate was 31% lower in the ICD group than in the conventional-therapy group (14.2…

Reviewing Author

Hugh Calkins, MD