Current Cardiology Reports

, Volume 14, Issue 3, pp 299–307 | Cite as

The Timing of Implantable Cardioverter-Defibrillator Implantation in Patients with Heart Failure

Congestive Heart Failure (J Lindenfeld, Section Editor)

Abstract

Patients who survive a myocardial infarction (MI) are at increased risk of sudden death due to fatal ventricular arrhythmias. Implantable cardioverter-defibrillators (ICDs) reduce mortality in appropriately selected patients with heart failure and left ventricular dysfunction, regardless of etiology. Post hoc analyses from landmark trials have evaluated the effect of time (both since MI and duration of nonischemic cardiomyopathy) before ICD implantation on the efficacy of ICD therapy. Time remains a clinically important variable in the decision of if and when to implant an ICD. Future trials should focus on invasive and/or noninvasive risk stratification of patients with ischemic and nonischemic cardiomyopathy for better identification of those who would benefit from early ICD implantation, and those in whom a watch and wait approach is appropriate.

Keywords

Implantable cardioverter-defibrillator Heart failure Myocardial infarction Nonischemic cardiomyopathy Sudden cardiac death 

Clinical Trial Acronyms

AMIOVIRT

Amiodarone Versus Implantable Cardioverter-Defibrillator

CABG-Patch

Coronary Artery Bypass Graft-Patch

CAT

Cardiomyopathy Trial

DEFINITE

Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation

DINAMIT

Defibrillator in Acute Myocardial Infarction Trial

IRIS

Immediate Risk-Stratification Improves Survival

MADIT-I

Multicenter Automatic Defibrillator Implantation Trial-I

MADIT-II

Multicenter Automatic Defibrillator Implantation Trial-II

MUSTT

Multicenter Unsustained Tachycardia Trial

REFINE-ICD

Risk Estimation Following Infarction Noninvasive Evaluation—ICD Efficacy

SCD-HeFT

Sudden Cardiac Death in Heart Failure

VALIANT

Valsartan in Acute Myocardial Infarction Trial

VEST

Vest Prevention of Early Sudden Death Trial

Notes

Disclosure

No potential conflicts of interest relevant to this article were reported.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Mazankowski Alberta Heart InstituteUniversity of AlbertaEdmontonCanada

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