Key result
ICD therapy reduces total mortality ~40% in heart transplant waitlist candidates.
Why the study?
Survival during the pretransplant waitlist time for heart transplant candidates remains a significant challenge despite improvements in waitlist survival rates.
May warrant ICD consideration in transplant candidates; extends observational data but leaves open need for randomized confirmation.
Heart transplantation remains the only curative therapy for end-stage heart failure, offering excellent 5-year survival rates of up to 72% for patients with otherwise extremely bleak prognostic outlooks.1 However, a significant challenge for heart transplant candidates is surviving the pretransplant waitlist time, which can be considerable owing to donor organ availability. Reassuringly, waitlist survival rates have improved dramatically in recent years, with 1-year survival on the waitlist increasing from 34.1% in 1987–1990 to 67.8% in 2011–2017.
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Ariyaratnam et al. (2021) conducted an editorial in End-stage heart failure awaiting heart transplantation (n=36,112). Implantable cardioverter-defibrillator (ICD) vs. No ICD was evaluated on Total mortality (40% reduction (RR 0.60)). ICD therapy conferred a statistically significant 40% reduction in total mortality, 73% reduction in sudden cardiac death, and a 9% increased chance of surviving to heart transplantation among waitlisted candidates.
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