Implantable Cardioverter-Defibrillators for Primary Prevention in Patients With Ischemic or Nonischemic Cardiomyopathy

Letters6 February 2018Implantable Cardioverter-Defibrillators for Primary Prevention in Patients With Ischemic or Nonischemic CardiomyopathyRahman Shah, MDRahman Shah, MDUniversity of Tennessee School of Medicine, Memphis, Tennessee (R.S.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0690 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:On the basis of data pooled from SCD-HeFT, AMIOVIRT (Amiodarone Versus Implantable Cardioverter-Defibrillator Randomized Trial), CAT (Cardiomyopathy Trial), DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation), and DANISH, Kołodziejczak and colleagues conclude that prophylactic ICDs compared with conventional therapy reduce all-cause mortality in patients with nonischemic cardiomyopathy (1). However, they considered recipients of “conventional therapy” from SCD-HeFT to be both the placebo and amiodarone groups. This factor affects the generalizability of their results. Amiodarone is not a guideline-based therapy for nonischemic cardiomyopathy. It might be harmful if used for primary prevention, particularly in patients with advanced heart failure; ...References1. Kołodziejczak M, Andreotti F, Kowalewski M, Buffon A, Ciccone MM, Parati G, et al. Implantable cardioverter-defibrillators for primary prevention in patients with ischemic or nonischemic cardiomyopathy: a systematic review and meta-analysis. Ann Intern Med. 2017;167:103-11. [PMID: 28632280]. doi:10.7326/M17-0120 LinkGoogle Scholar2. Køber L, Thune JJ, Nielsen JC, Haarbo J, Videbæk L, Korup E, et al; DANISH Investigators. Defibrillator implantation in patients with nonischemic systolic heart failure. N Engl J Med. 2016;375:1221-30. [PMID: 27571011] doi:10.1056/NEJMoa1608029 CrossrefMedlineGoogle Scholar3. Epstein AE, DiMarco JP, Ellenbogen KA, Estes NA, Freedman RA, Gettes LS, et al; American College of Cardiology Foundation. 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Circulation. 2013;127:e283-352. [PMID: 23255456] doi:10.1161/CIR.0b013e318276ce9b CrossrefMedlineGoogle Scholar4. Tricoci P, Allen JM, Kramer JM, Califf RM, Smith SC. Scientific evidence underlying the ACC/AHA clinical practice guidelines. JAMA. 2009;301:831-41. [PMID: 19244190] doi:10.1001/jama.2009.205 CrossrefMedlineGoogle Scholar5. Neuman MD, Goldstein JN, Cirullo MA, Schwartz JS. Durability of class I American College of Cardiology/American Heart Association clinical practice guideline recommendations. JAMA. 2014;311:2092-100. [PMID: 24867012] doi:10.1001/jama.2014.4949 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Tennessee School of Medicine, Memphis, Tennessee (R.S.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0690. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoImplantable Cardioverter-Defibrillators for Primary Prevention in Patients With Ischemic or Nonischemic Cardiomyopathy Michalina Kołodziejczak , Felicita Andreotti , Mariusz Kowalewski , Antonino Buffon , Marco Matteo Ciccone , Gianfranco Parati , Pietro Scicchitano , Julia M. Umińska , Stefano De Servi , Kevin P. Bliden , Jacek Kubica , Alessandro Bortone , Filippo Crea , Paul Gurbel , and Eliano P. Navarese Implantable Cardioverter-Defibrillators for Primary Prevention in Patients With Ischemic or Nonischemic Cardiomyopathy Laszlo Littmann Implantable Cardioverter-Defibrillators for Primary Prevention in Patients With Ischemic or Nonischemic Cardiomyopathy Michalina Kołodziejczak , Felicita Andreotti , and Eliano Pio Navarese Metrics 6 February 2018Volume 168, Issue 3Page: 233-234KeywordsCardiomyopathiesConflicts of interestDisclosureHeart failureImplantable cardioverter defibrillatorsMortalityRandomized trialsRisk ratioTreatment guidelinesVentricular tachycardia ePublished: 6 February 2018 Issue Published: 6 February 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...