Key result
Early ICD implantation after acute MI fails to reduce mortality compared to deferred placement.
Why the study?
Randomized studies of ICD use early after acute MI failed to show mortality benefit, leading to guidelines recommending deferral of ICD implantation for at least 40 days.
Does early implantable cardioverter defibrillator (ICD) implantation reduce mortality in patients with acute myocardial infarction compared to deferring implantation for at least 40 days?
Does early implantable cardioverter defibrillator (ICD) implantation reduce mortality in patients with acute myocardial infarction compared to deferring implantation for at least 40 days?
This review discusses the limitations of trials evaluating early ICD implantation post-MI and the rationale behind the guideline recommendation to defer ICD implantation for at least 40 days.
Until recently, randomized studies of implantable cardioverter defibrillator (ICD) have only included patients with a remote history of myocardial infarction (MI). Two studies evaluated the use of ICDs early following MI, the DINAMIT and BEST+ICD studies, but failed to demonstrate significant reduction in mortality. Current guidelines therefore recommend deferring ICD implantation for at least 40 days following MI. This article highlights the limitations of these two studies and reviews the application of the '40-day' rule to patients with acute MI.
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Lim et al. (2008) conducted a review in Acute myocardial infarction. Implantable cardioverter defibrillator (ICD) was evaluated on Mortality. Early use of implantable cardioverter defibrillators following acute myocardial infarction failed to demonstrate a significant reduction in mortality in the DINAMIT and BEST+ICD studies.
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