MADIT-II: clinical implications.
The MADIT-II trial showed that in patients with a prior myocardial infarction and ejection fraction </=0.30, prophylactic implantation of a defibrillator improves survival with a 31% reduction in mortality during an average follow-up of 20 months. Electrophysiologic inducibility was positive in 36% of patients at the time of ICD implantation. Inducibility was associated with increased ICD utilization for ventricular tachycardia during long-term follow-up, and decreased utilization for ventricular fibrillation. These preliminary findings raise questions about the clinical usefulness of electrophysiologic testing as a risk stratifier in patients with advanced left ventricular dysfunction.
Moss
Arthur J
AJ
Cardiology Unit, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA. heartajm@heart.rochester.edu
Daubert
James
J
Zareba
Wojciech
W
D000328:Adult; D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006334:Heart Function Tests; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D011336:Probability; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications* / Q000175:diagnosis / Q000401:mortality
D000889:Anti-Arrhythmia Agents