title: Debate: Do all patients with heart failure require implantable defibrillators to prevent sudden death?
abstract: 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.
authors.affiliation: University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA. hsiah@mail.med.upenn.edu
authors.forename: Henry H
authors.initials: HH
authors.lastname: Hsia
authors.forename: Mariell L
authors.initials: ML
authors.lastname: Jessup
authors.forename: Francis E
authors.initials: FE
authors.lastname: Marchlinski