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Prophylactic implantable cardioverter defibrillator trials: MUSTT, MADIT, and beyond

      Dr. Michel Mirowski, the inventor of the implantable cardioverter defibrillator (ICD), envisioned it as a prophylactic device for primary prevention of sudden cardiac death (SCD).
      • Kastor J
      Historical study. Michel Mirowski and the automatic implantable defibrillator.
      However, it was appropriate to first demonstrate the safety and efficacy of the ICD in secondary prevention of SCD in patients with known life-threatening sustained ventricular tachycardia (VT-S) or ventricular fibrillation (VF). By the end of the first decade of ICD therapy, its efficacy in virtually eliminating SCD due to VT/VF was well established,
      • Winkle R
      • Mead H
      • Ruder M
      • Gaudiani V.A
      • Smith N.A
      • Buch W.S
      • Schmidt P
      • Shipman T
      Long-term outcome with the automatic implantable cardioverter defibrillator.
      ,
      • Akhtar M
      • Avitall B
      • Jazayeri M
      • Tchou P
      • Troup P
      • Sra J
      • Axtell K
      Role of implantable cardioverter defibrillator therapy in the management of high-risk patients.
      opening the door to investigations into the role of the ICD as a primary prophylaxis.
      • Nisam S
      • Thomas A
      • Mower M
      • Hauser R
      Identifying patients for prophylactic automatic implantable cardioverter defibrillator therapy status of prospective studies.
      ,
      • Moss A
      • Hall J
      • Cannom D
      • Daubert J
      • Higgins S
      • Klein H
      • Levine J
      • Saksena S
      • Waldo A
      • Wilber D
      • Brown M
      • Heo M
      MADIT Investigators
      Improved survival with an implanted defibrillator in patients with coronary disease at high risk of ventricular arrhythmias.
      ,
      • Buxton A
      • Lee K
      • Fisher J
      • Josephson M
      • Prystowsky E
      • Haffly G
      Multicenter UnSustained Tachycardia Trial (MUSTT) Investigators
      A randomized study of the prevention of sudden death in patients with coronary artery disease.
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