December 1, 1995Circulation
Influence of the Implantable Cardioverter/Defibrillator on Sudden Death and Total Mortality in Patients Evaluated for Cardiac Transplantation
Why the study?
Does an implantable cardioverter/defibrillator reduce sudden death and total mortality in patients evaluated for cardiac transplantation?
Population
291 consecutive patients with severe left ventricular dysfunction evaluated for cardiac transplantation…
Comparison
Implantable cardioverter/defibrillators vs Antiarrhythmic drugs or no antiarrhythmic…
Design
Cohort
Follow-up
mean 15 months (range, 1 to 118 months)
Authors
Discussion
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Implication
ICDs may reduce sudden death without improving survival in transplant candidates; leaves open randomized assessment of competing nonsudden mortality risks.
Structured PICO
Does an implantable cardioverter/defibrillator reduce sudden death and total mortality in patients evaluated for cardiac transplantation?
P
Population
291 consecutive patients with severe left ventricular dysfunction evaluated for cardiac transplantation between January 1986 and January 1995
I
Intervention
Implantable cardioverter/defibrillators (ICDs) (n=59)
C
Comparator
Antiarrhythmic drugs (n=53) or no antiarrhythmic treatment (n=179)
O
Outcome
Total mortality and mode of cardiac death (sudden, nonsudden, and noncardiac)hard clinical
In patients with severe left ventricular dysfunction awaiting cardiac transplantation, ICDs reduce sudden death but do not improve overall survival due to a competing high rate of nonsudden death.
Cite This Study
Sweeney et al. (1995) studied this question.