Debate: Do all patients with heart failure require implantable defibrillators to prevent sudden death?
Sudden death is a major cause of mortality in patients with ventricular dysfunction. The highest risk occurs among patients with less severe functional impairment. Current methods of risk stratification are inadequate, and a rational therapy for prevention of sudden death is not available. The implantable cardioverter-defibrillator (ICD) has proven to be more effective than drugs in reducing sudden-death risk in some subsets of patients. Empiric ICD therapy, targeting the general population with mild to moderate heart failure, will maximize the impact of such a strategy to prevent sudden death and improve long-term survival.
Hsia
Henry H
HH
University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA. hsiah@mail.med.upenn.edu
Jessup
Mariell L
ML
Marchlinski
Francis E
FE