ICD Therapy: Can It Prevent Sudden Death in CHF Patients?
Implantable cardioverter defibrillator (ICD) therapy has greatly decreased the risk of sudden death in patients with reduced heart function. However, the ICD may be limited in improving the prognosis in these patients. More patients who received consecutive discharges died than did those patients who received only single discharges or no discharges at all. In our study, six of seven patients with severely reduced heart function who had consecutive discharges died. Treatment with only ICD therapy may be limited in improving the prognosis in these patients, and therefore we should consider using amiodarone or a β-blocker combined with ICD therapy. In our study, there was no difference in the number of patients who received ICD discharges between those treated or not treated with amiodarone plus β-blockers. However, there were no patients who received consecutive discharges or who died in the group of patients treated with amiodarone plus β-blockers. Our findings suggested that although concomitant therapy with amiodarone plus β-blockers was effective in increasing the electrical stability necessary to terminate VT/VF by a single discharge from an ICD, and this effect contributed to improving the prognosis.
Key wordsImplantable cardioveter defibrillator Heart failure Amiodarone β-Blocker Sudden death
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