How does the risk for mortality vary among different patient groups with implantable cardioverter-defibrillators (ICDs)?

Updated: Feb 13, 2017
  • Author: Daniel M Beyerbach, MD, PhD; Chief Editor: Jeffrey N Rottman, MD  more...
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Answer

Levy et al found that in patients with moderately symptomatic heart failure with an ejection fraction of 35% or less, primary prevention with an ICD provides no benefit in some cases but substantial benefit in others, and that ICD benefit can be predicted. Analysis of data from the placebo arm of SCD-HeFT showed that patients could be classified into 5 groups on the basis of predicted 4-year mortality. In the treatment arm, ICD implantation decreased relative risk of sudden cardiac death by 88% in patients with the lowest baseline mortality risk, versus 24% in the highest-risk group. ICD treatment decreased relative risk of total mortality by 54% in the lowest-risk group but provided no benefit (2%) in the highest-risk group. [23]


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