Proportion of patients followed in a specialized heart failure clinic needing an implantable cardioverter defibrillator as determined by applying different trial eligibility criteria

The American Journal of Cardiology
Mustafa TomaPaul W Armstrong

Abstract

Numerous trials have demonstrated survival benefits using implantable cardioverter defibrillators (ICDs) for primary prevention in selected patients with left ventricular (LV) systolic dysfunction. However, eligibility criteria differed across these trials. Without a risk stratification scheme that clearly identifies those who will benefit, there remains debate about which patients with heart failure (HF) should receive ICDs for primary prevention. To explore the implications of applying different eligibility criteria, this study evaluated all patients seen in a specialized HF clinic from August 2003 to January 2004. Of the 309 consecutive patients in the cohort, 46 were excluded because their HF complicated recent myocardial infarcts (n = 3); their LV ejection fractions were not measured (n = 9); or their HF was due to valvular disease, myocarditis, or peripartum cardiomyopathy (n = 34). The Multicenter Automatic Defibrillator Implantation Trial-II criteria were met by 85 patients (32%), and 134 patients (51%) met the Sudden Cardiac Death in Heart Failure Trial criteria. Even allocation decisions based on randomized trial evidence can have vastly different resource implications depending on which trial is chosen. Thus, the dev...Continue Reading

References

Mar 22, 2002·The New England Journal of Medicine·Arthur J MossUNKNOWN Multicenter Automatic Defibrillator Implantation Trial II Investigators
May 21, 2004·The New England Journal of Medicine·Alan KadishUNKNOWN Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation (DEFINITE) Investigators
Dec 14, 2004·The New England Journal of Medicine·Sandeep Jauhar, David J Slotwiner
Jan 22, 2005·The New England Journal of Medicine·Mark B McClellan, Sean R Tunis
Jan 22, 2005·The New England Journal of Medicine·Gust H BardyUNKNOWN Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators
Apr 20, 2005·Annals of Internal Medicine·Sana M Al-KhatibRobert M Califf
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Citations

Apr 20, 2010·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Roberto F E PedrettiUNKNOWN ALPHA Study Group Investigators
Oct 24, 2009·Internal Medicine Journal·S ThavapalachandranP Sanders
May 23, 2008·European Journal of Heart Failure·Habitha M SulaimanKenneth McDonald
Aug 8, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Kristin J LyonsJustin A Ezekowitz
Jun 30, 2007·Journal of the American College of Cardiology·Douglas S LeeAndreas Laupacis
Jan 24, 2017·The Canadian Journal of Cardiology·Ratika ParkashMiroslaw Rajda
Oct 25, 2014·The Open Cardiovascular Medicine Journal·Hisham DokainishStuart Connolly

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