Abstract
Over the past decade, four randomized, controlled trials have evaluated therapies for prevention of sudden cardiac death in patients with coronary disease. Three of the four trials have shown significant reductions in mortality with implanted defibrillators. Two studies failed to demonstrate any benefit from pharmacologic antiarrhythmic therapy. The results of these studies in similar patient populations have erased any doubt regarding the ability of implanted defibrillators to reduce the risk of sudden death in patients with coronary disease. Our major challenge at this time is understanding how best to utilize this therapy in order to bring the benefit to the maximum number of patients while minimizing expense.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Zheng Z-J, Croft JB, Giles WH, et al. Sudden cardiac death in the United States, 1989 to 1998. Circulation 2001;104:2158–2163.
The Antiarrhythmics versus Implantable Defibrillators (AVID) investigators. A comparison of antiarrhythmicdrug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. New England Journal of Medicine 1997;337:1576–1583.
Moss AJ, Hall WJ, Cannom DS, et al. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter automatic defibrillator implantation trial investigators. New England Journal of Medicine 1996;335:1933–1940.
Buxton AE, Lee KL, Fisher JD, et al. A randomized study of the prevention of sudden death in patients with coronary artery disease. New England Journal of Medicine 1999;341:1882–1890.
Lee KL, Hafley G, Fisher JD, et al. Effect of implantable defibrillators on arrhythmic events and mortality in the multicenter unsustained tachycardia trial. Circulation 2002;106:233–238.
Moss AJ, Zareba W, Hall WJ, et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med 2002:NEJMoa013474.
Moss AJ, Fadl Y, Zareba W, et al. Survival benefit with an implanted defibrillator in relation to mortality risk in chronic coronary heart disease. American Journal of Cardiology 2001;88:516–520.
Bigger J. The Coronary Artery Bypass Graft (CABG) patch trial investigators. Prophylactic use of implanted cardiac defibrillators in patients at high risk for ventricular arrhythmias after Coronary-Artery Bypass Graft Surgery. N Engl J Med 1997;337:1569–1575.
Bigger JT, Whang W, Rottman JN, et al. Mechanisms of death in the CABG patch trial. Circulation 1999;99:1416–1421.
Buxton AE, Lee KL, DiCarlo L, et al. Electrophysiologic testing to identify patients with coronary artery disease who are at risk for sudden death. New England Journal of Medicine 2000;342:1937–1945.
Ruskin JN, Camm AJ, Zipes DP, et al. Implantable cardioverter defibrillator utilization based on discharge diagnoses from medicare and managed care patients. Journal of Cardiovascular Electrophysiology 2002;13:38–43.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Buxton, A.E., Ellison, K.E., Kirk, M.M. et al. Primary Prevention of Sudden Cardiac Death: Trials in Patients with Coronary Artery Disease. J Interv Card Electrophysiol 9, 203–206 (2003). https://doi.org/10.1023/A:1026236524273
Issue Date:
DOI: https://doi.org/10.1023/A:1026236524273