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Implantable cardioverter-defibrillators have been shown to prolong life in patients with ischemic and nonischemic cardiomyopathies and LV ejection fractions ≤35%. The use of these devices for primary prevention of sudden cardiac death in patients without prior arrhythmias has been explored in two major trials: SCD-HeFT and MADIT-II. In a clinical outcomes study, MADIT II investigators have previously shown that appropriate and inappropriate ICD shocks predict increased mortality in such patients (JW Cardiol Mar 4 2005). Now, the SCD-HeFT investigators report their findings on these outcomes.
During a median follow-up of about 45 months, 269 of 811 patients with ICDs received shocks (ICD programming in this trial did not include antitachycard…