Key result
ICD therapy reduces total mortality and sudden cardiac death in nonischemic dilated cardiomyopathy, though benefits may be diminished with optimal medical therapy and cardiac resynchronization.
Why the study?
Does implantable cardioverter defibrillator (ICD) therapy reduce total mortality and sudden cardiac death in patients with nonischemic dilated cardiomyopathy?
Does implantable cardioverter defibrillator (ICD) therapy reduce total mortality and sudden cardiac death in patients with nonischemic dilated cardiomyopathy?
ICD therapy is recommended for primary prevention of sudden cardiac death in patients with nonischemic dilated cardiomyopathy, LVEF ≤35%, and NYHA class II-III, with biventricular pacing combined with an ICD recommended for those with QRS ≥120 ms and NYHA class III-IV.
May reinforce primary-prevention ICD recommendations; leaves open incremental benefit with contemporary GDMT and CRT.
Risk stratification of patients before considering implantable cardioverter defibrillator (ICD) therapy is important for targeting therapy. Recommendations for selecting the optimal patients for ICD therapy are based on major trials. For patients with nonischemic dilated cardiomyopathy, left ventricular ejection fraction (LVEF) ≤35%, and associated heart failure (HF) with New York Heart Association (NYHA) functional Class II or III status, ICD therapy for primary prevention of sudden cardiac death (SCD) is recommended. ICDs are effective at reducing total mortality and mortality from SCD, although the benefits of an ICD on total mortality may be diminished in the setting of guideline-directed optimal medical therapy and cardiac resynchronization therapy. For patients with an LVEF ≤35%, HF with NYHA functional Class III or IV status, and a QRS duration ≥120 milliseconds, biventricular pacing combined with an ICD is recommended.
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Ramakumar et al. (2018) conducted a review in Nonischemic cardiomyopathy. Implantable cardioverter defibrillator (ICD) was evaluated. ICD therapy reduces total mortality and sudden cardiac death in nonischemic dilated cardiomyopathy, though benefits may be diminished with optimal medical therapy and cardiac resynchronization.
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