ESC Congress 2003
Sudden cardiac death from ventricular tachyarrhythmias is the leading cause of death in Europe and the US. It effects hundreds of thousands people each year. Many of them have known heart disease, mainly coronary artery disease. The implantable defibrillator (ICD) effectively treats such arrhythmias and prevents sudden cardiac death. Identification of patients at risk who may gain profit from prophylactic ICD implantation remains a difficult task for the cardiologist.
The Multicenter Automatic Defibrillator Implantation Trial II (MADIT II) enrolled patients with a history of myocardial infarction and severely depressed left ventricular function without a history of life-threatening arrhythmias. The study was supported by an unrestricted research grant from GUIDANT, St.Paul, Minn. Patients were randomized to receive best medical therapy only or ICD implantation on top of best therapy. Over the course of four years 1232 patients were enrolled from 71 centers in the US and 5 centers in Europe. After a mean follow-up of 20 months, ICD therapy was associated with a 31 percent reduction in the risk of death.
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