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Multiple randomized, controlled trials have shown that patients benefit from implantable cardioverter–defibrillators (ICDs) for both secondary and primary prophylaxis. However, all of these studies have excluded patients on dialysis even though sudden cardiac death (SCD) is frequent in these patients, including those with preserved left ventricular ejection fraction (LVEF). In the manufacturer-sponsored ICD2 study (ISRCTN20479861), 188 patients on dialysis with LVEF ≥35% were randomized to receive or not receive ICDs.
Through follow-up (median, 6.8 years), SCD occurred in 11% of the ICD group and 9% of the control group. Over 50% of the participants died, with no difference between the ICD and control groups. In the ICD group, 14% received a…