Home Cardiology No Drop in All-Cause Mortality With ICD in Systolic Heart Failure

No Drop in All-Cause Mortality With ICD in Systolic Heart Failure

Significantly lower risk of sudden cardiac death for patients with ICD versus usual clinical care

MONDAY, Aug. 29, 2016 (HealthDay News) — For patients with symptomatic systolic heart failure not caused by coronary artery disease, an implantable cardioverter-defibrillator (ICD) does not reduce the risk of all-cause mortality, according to a study published online Aug. 28 in the New England Journal of Medicine. The research was published to coincide with the annual European Society of Cardiology Congress, held from Aug. 27 to 31 in Rome.

Lars Køber, M.D., from University Hospital in Copenhagen, Demark, and colleagues conducted a randomized controlled trial involving patients with symptomatic systolic heart failure not caused by coronary artery disease who were assigned to receive an ICD (556 patients) or usual clinical care (560 patients).

The researchers found that the primary outcome of death from any cause occurred in 21.6 percent of the ICD group and 23.4 percent of the control group, after a median follow-up period of 67.6 months (hazard ratio, 0.87; 95 percent confidence interval, 0.68 to 1.12). Sudden cardiac death occurred in 4.3 and 8.2 percent of the ICD and control groups, respectively (hazard ratio, 0.50; 95 percent confidence interval, 0.31 to 0.82). Device infection occurred in 4.9 and 3.6 percent of patients in the ICD and control groups, respectively (P = 0.029).

“In this trial, prophylactic ICD implantation in patients with symptomatic systolic heart failure not caused by coronary artery disease was not associated with a significantly lower long-term rate of death from any cause than was usual clinical care,” the authors write.

The study was funded by Medtronic.

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