Key result
Prophylactic ICD implantation did not significantly reduce total mortality compared to no antiarrhythmic therapy (HR 1.07, P=0.63), because 71% of deaths were nonarrhythmic.
Why the study?
Does prophylactic ICD implantation reduce arrhythmic and nonarrhythmic deaths in coronary bypass surgery patients with LVEF <0.36 and abnormal signal-averaged ECG?
Population
900 coronary bypass surgery patients with left ventricular ejection fraction <0.36 and an abnormal…
Comparison
Prophylactic implantable cardiac-defibrillator… vs No antiarrhythmic therapy
Design
RCT
Follow-up
42 months
Authors
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Focus on clinical action + research context):**.
RCT (n=900)
Does prophylactic ICD implantation reduce arrhythmic and nonarrhythmic deaths in coronary bypass surgery patients with LVEF <0.36 and abnormal signal-averaged ECG?
Effect estimate: HR 1.07
Absolute Event Rate: 22.9% vs 21.1%
p-value: p=0.63
Prophylactic ICD implantation in high-risk CABG patients reduces arrhythmic death but does not improve overall survival due to a high competing risk of nonarrhythmic death.
Bigger et al. (1999) conducted an RCT in Coronary bypass surgery patients with left ventricular ejection fraction <0.36 and abnormal signal-averaged ECG (n=900). Prophylactic implantable cardiac-defibrillator (ICD) vs. No antiarrhythmic therapy was evaluated on Total mortality (HR 1.07, p=0.63). Prophylactic ICD implantation did not significantly reduce total mortality compared to no antiarrhythmic therapy (HR 1.07, P=0.63), because 71% of deaths were nonarrhythmic.
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