Key result
ICD therapy cuts total mortality ~34% across ischemic and non-ischemic cardiomyopathy.
Why the study?
Although ICDs and CRT reduce mortality, not all patients benefit to the same extent and both devices remain underutilized in many countries.
Effect estimate: RR 0.66 (95% CI 0.6-0.73)
p-value: p=<0.001
ICD and CRT are essential, guideline-directed therapies for heart failure that require careful patient selection to maximize benefit and minimize non-response.
Despite advances in heart failure treatment, this condition remains a relevant medical issue and is associated with a high morbidity and mortality. The cause of death in patients suffering from heart failure is not only a result of hemodynamic failure, but can also be due to ventricular arrhythmias. Implantable cardioverter defibrillators (ICDs) are these days the only tool to significantly reduce arrhythmic sudden death; but not all patients benefit to the same extend. In addition, cardiac resynchronization therapy (CRT) is another tool which is used in patients suffering from heart fialure. Even though both devices have been investigated in large randomized trials, both ICD and CRT remain underutilized in many countries. This brief review focuses on various aspects in this regard including a short overview on upcoming device novelties in the near future.
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Breitenstein et al. (2019) conducted a review in Heart failure. Implantable cardioverter defibrillator (ICD) vs. Placebo or optimal medical therapy was evaluated on Reduction in total mortality (RR 0.66, 95% CI 0.6-0.73, p=<0.001).
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