Journal Article

Prophylactic Defibrillator Implantation in Patients with Nonischemic Dilated Cardiomyopathy

Dyer, Alan, Hoch, David, Quigg, Rebecca, Shalaby, Alaa, Anderson, Kelley P, Kadish, Alan, Daubert, James P, Calkins, Hugh, Goldberger, Jeffrey, Levine, Joseph H, Sanders, William E, Schaechter, Andi, Estes, N.A. Mark

2004

Overview

Patients with left ventricular dysfunction due to nonischemic dilated cardiomyopathy are at substantial risk for sudden death from ventricular arrhythmias. This study found that prophylactic implantation of a cardioverter–defibrillator did not improve overall survival but significantly reduced the risk of death from cardiac arrhythmias. Prophylactic implantation of a cardioverter–defibrillator did not improve overall survival. Patients with nonischemic dilated cardiomyopathy often die suddenly. 1 Although therapy with angiotensin-converting–enzyme (ACE) inhibitors and beta-blockers has increased survival in clinical trials of patients with left ventricular dysfunction due to nonischemic and ischemic cardiomyopathies, such patients still have a substantial risk of sudden death from cardiac causes despite receiving adequate doses of both pharmacologic agents. 2 , 3 The implantable cardioverter–defibrillator (ICD) prevents sudden death in patients who have had an episode of ventricular tachycardia or cardiac arrest, 4 as well as in selected patients who have coronary disease and left ventricular dysfunction. 5 – 7 However, no large-scale studies have examined the role of . . .

• Publisher: Massachusetts Medical Society
• Subject: Adrenergic beta-Antagonists - therapeutic use / Adult / Aged / Aged, 80 and over / Angiotensin-Converting Enzyme Inhibitors - therapeutic use / Arrhythmias, Cardiac - complications / Arrhythmias, Cardiac - mortality / Biological and medical sciences / Cardiology. Vascular system / Cardiomyopathy, Dilated - complications / Cardiomyopathy, Dilated - drug therapy / Cardiomyopathy, Dilated - mortality / Cardiomyopathy, Dilated - therapy / Cardiovascular disease / Combined Modality Therapy / Death & dying / Death, Sudden, Cardiac - etiology / Death, Sudden, Cardiac - prevention & control / Defibrillators / Defibrillators, Implantable / Female / General aspects / Heart / Humans / Male / Medical sciences / Middle Aged / Mortality / Myocarditis. Cardiomyopathies / Stroke Volume / Transplants & implants / Ventricular Dysfunction, Left - complications / Ventricular Dysfunction, Left - therapy