Implantable Cardioverter-Defibrillators After MI: Keep the Brakes On

Results of a randomized trial confirm that early ICD implantation fails to improve survival.

Patients with relatively recent MIs were excluded from the landmark trials showing that implantable cardioverter-defibrillators improve survival in patients with ischemic heart disease and low LV ejection fractions (JW Cardiol Mar 4 2005). In the DINAMIT trial, which was restricted to patients with recent MIs, ICD implantation reduced the incidence of arrhythmia-related sudden cardiac death but failed to reduce all-cause mortality (JW Cardiol Jan 28 2005).

In the European IRIS trial, investigators randomized 898 patients to receive or not to receive an ICD within 31 days after MI. All participants met at least one of two criteria for high-risk status: LVEF of ≤40% and heart rate of ≥90 beats per minute; or nonsustained ventricular tachycardi…

Reviewing Author

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate

Mark S. Link, MD

Disclosures

Editorial BoardsCirculation; UpToDate