Prophylactic Use of an Implantable Cardioverter‐Defibrillator After Acute Myocardial Infarction

674 patients aged 18-80 years who had a recent acute myocardial infarction (6-40 days previously, average 18 days), reduced left ventricular function (LVEF ≤35%, mean 28%), and impaired cardiac autonomic function (manifested as depressed heart-rate variability or an elevated average 24-hour heart rate on Holter monitoring).

Prophylactic implantation of a market-approved, single-chamber implantable cardioverter-defibrillator (ICD) within 1 week after randomization, added to current standard medical therapy.

No ICD therapy, receiving current standard medical therapy (including angiotensin-converting enzyme inhibitors, beta blockers, aspirin, and lipid-lowering drugs).

Mortality from any causehard clinical