What’s the Best Drug Therapy for Preventing ICD Shocks?

Implantable-cardioverter defibrillators (ICDs) prolong the survival of many patients by delivering lifesaving, though painful, shocks for ventricular tachycardia (VT) or ventricular fibrillation (VF). In addition to these appropriate shocks, ICDs sometimes deliver unnecessary shocks for atrial arrhythmias. By suppressing arrhythmias, antiarrhythmic drugs have the potential to prevent the need for lifesaving shocks and to avoid unnecessary shocks. But do they perform any better than standard beta-blocker therapy alone?

Researchers addressed this question in an international trial involving 412 patients (mean age, 64; 80% men; maximum LV ejection fraction, 40%) who had recently received St. Jude Medical dual-chamber ICDs for inducible or spont…