PMID: 11899573Mar 20, 2002Paper

In patients with heart failure, do implantable cardioverter-defibrillators delay death or save lives?

Italian heart journal. Supplement : official journal of the Italian Federation of Cardiology
Massimo Zoni BerissoStefano Viani

Abstract

Heart failure is one of the most important public health problems in western countries because of its frequent association with cardiac death and with rehospitalization. Patients with heart failure generally die of sudden arrhythmic death (SD) and progressive pump failure with a SD incidence inversely related to the severity of the underlying heart disease. SD occurs approximately in one half of the patients in New York Heart Association (NYHA) functional classes II-II/III and in one third of those in NYHA classes III/IV-IV, respectively. In the last decade, numerous studies have shown that the automatic implantable cardioverter-defibrillator (ICD) significantly reduces the incidence of SD in those patients who are identified as being at risk. Unfortunately, little is known on whether the ICD actually prolongs the survival of the subgroup of patients with most severe heart failure. The main reasons for such a paucity of information are the small number of available studies, the unavailability of randomized and controlled investigations and the difficulty in comparing the results of such studies owing to the lack of homogeneity. In patients with severe heart failure, both the perioperative mortality and morbidity related to tran...Continue Reading

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