Open AccessProphylactic Trials With Implantable Cardioverter Defibrillators: MADIT and Beyond
Author(s) -
NISAM SEAH,
SINGER IGOR
Publication year - 1998
Publication title -
journal of interventional cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.764
H-Index - 51
eISSN - 1540-8183
pISSN - 0896-4327
DOI - 10.1111/j.1540-8183.1998.tb00123.x
Subject(s) - medicine , implantable cardioverter defibrillator , sudden cardiac death , intensive care medicine , ventricular fibrillation , clinical trial , primary prevention , cardiology , disease
Numerous studies have proven the efficacy of the ICD in prolonging life, both in patients with previous history of ventricular tachyarrhythmias and in patients such as in MADIT, without such arrhythmias, but at a high risk of VT or VF. Nevertheless, this therapy has had relatively small impact on reducing the overall problem of sudden cardiac death, simply because the populations treated using currently accepted indications make up a tiny portion of at‐risk patients. There are numerous studies aiming to further clarify which patients can benefit from ICDs for primary prevention. One of these, CABG‐Patch, has finished, with a neutral result. The only certain implication is that patients destined for CABG surgery and having no further specific arrhythmia risk markers should not receive ICDs. Other studies have recently begun, and it will be several years before their results are known. The proven efficacy of the ICD for therapy of VT and VF has, in fact, introduced new feasibility and ethical considerations in designing future clinical trials.