Prophylactic Implantable Cardioverter–Defibrillators after Myocardial Infarction — Not for Everyone

A number of clinical trials have been reported to show that the implantable cardioverter–defibrillator (ICD) prevents sudden death from cardiac causes and significantly reduces overall mortality among patients with left ventricular dysfunction in the setting of ischemic heart disease.14 Some of these studies included patients with other risk factors for sudden death from cardiac causes, such as nonsustained ventricular tachycardia on Holter monitoring and the induction of a sustained ventricular tachyarrhythmia during electrophysiological testing.1,3 As a consequence of these studies, the use of ICDs for the primary prevention of sudden death from cardiac causes has increased worldwide. However, . . .