The recent study by Zecchin et al
1
is an important contribution to the debate regarding the appropriate timing of prophylactic
implantable cardioverter-defibrillator (ICD) implantation for patients with idiopathic
dilated cardiomyopathy (DC). They have shown that with optimal medical therapy, 2/3
of patients with DC and “SCD-HeFT [Sudden Cardiac Death in Heart Failure] criteria”
at presentation
- Zecchin M.
- Merlo M.
- Pivetta A.
- Barbati G.
- Lutman C.
- Gregori D.
- Serdoz L.V.
- Bardari S.
- Magnani S.
- Di Lenarda A.
- Proclemer A.
- Sinagra G.
How can optimization of medical treatment avoid unnecessary implantable cardioverter-defibrillator
implantations in patients with idiopathic dilated cardiomyopathy presenting with “SCD-HeFT
criteria?”.
Am J Cardiol. 2012; 109: 729-735
2
did not maintain ICD indications 3 to 9 months later. We wish to extend these observations
by showing that even in patients with advanced heart failure and very low left ventricular
ejection fractions (LVEFs), intensive medical management without ICD implantation
can be associated with an exceptionally low 1-year mortality and, in many cases, with
an improvement of the LVEF to >35%.- Bardy G.H.
- Lee K.L.
- Mark D.B.
- Poole J.E.
- Packer D.L.
- Boineau R.
- Domanski M.
- Troutman C.
- Anderson J.
- Johnson G.
- McNulty S.E.
- Clapp-Channing N.
- Davidson-Ray L.D.
- Fraulo E.S.
- Fishbein D.P.
- Luceri R.M.
- Ip J.H.
Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators
Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure.
Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure.
N Engl J Med. 2005; 352: 225-237M
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References
- How can optimization of medical treatment avoid unnecessary implantable cardioverter-defibrillator implantations in patients with idiopathic dilated cardiomyopathy presenting with “SCD-HeFT criteria?”.Am J Cardiol. 2012; 109: 729-735
- Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure.N Engl J Med. 2005; 352: 225-237M
- Characteristics, outcomes, and predictors of 1-year mortality in patients hospitalized for acute heart failure.Eur Heart J. 2006; 27: 3011-3017
- National and regional trends in heart failure hospitalization and mortality rates for Medicare beneficiaries 1998-2008.JAMA. 2011; 306: 1669-1678
- Primary prevention of sudden cardiac death in idiopathic dilated cardiomyopathy: the Cardiomyopathy Trial (CAT).Circulation. 2002; 105: 1453-1458
- Patients with recently diagnosed nonischemic cardiomyopathy benefit from implantable cardioverter-defibrillators.J Am Coll Cardiol. 2006; 47: 2477-2482
- Incidence of left ventricular function improvement after primary prevention ICD implantation for non-ischemic dilated cardiomyopathy: a multicenter experience.Heart. 2010; 96: 510-515
Article Info
Publication History
Received:
April 4,
2012
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
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Access this article on ScienceDirectLinked Article
- How Can Optimization of Medical Treatment Avoid Unnecessary Implantable Cardioverter-Defibrillator Implantations in Patients With Idiopathic Dilated Cardiomyopathy Presenting With “SCD-HeFT Criteria?”American Journal of CardiologyVol. 109Issue 5
- PreviewTo assess the proportion and long-term outcomes of patients with idiopathic dilated cardiomyopathy and potential indications for implantable cardioverter-defibrillator before and after optimization of medical treatment, 503 consecutive patients with idiopathic dilated cardiomyopathy were evaluated from 1988 to 2006. A total of 245 patients (49%) satisfied the “Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) criteria,” defined as a left ventricular ejection fraction of ≤0.35 and New York Heart Association (NYHA) class II-III on registration.
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