ICDs vs. Amiodarone for Patients with HF and LV Dysfunction

New findings have influenced Medicare reimbursement policy for implantable-defibrillator therapy.

Both implantable cardioverter-defibrillator (ICD) therapy and pharmacologic therapy with amiodarone have been shown to prevent sudden death and prolong survival in specific patient populations. Now, in a head-to-head, partially industry-supported, multicenter trial, researchers compared these therapies in 2521 heart failure (HF) patients with left-ventricular ejection fractions (LVEFs) ≤35% (median, 25%).

Subjects were randomized to receive conventional HF therapy plus a placebo drug; conventional therapy plus amiodarone; or conventional therapy plus a conservatively programmed, shock-only, single-lead ICD. Placebo and amiodarone were administered in double-blind fashion. All subjects were in NYHA class II (70%) or III (30%); roughly half ha…

Reviewing Author

Hugh Calkins, MD