Primary prevention of sudden cardiac death: trials in patients with coronary artery disease.
Over the past decade, four randomized, controlled trials have evaluated therapies for prevention of sudden cardiac death in patients with coronary disease. Three of the four trials have shown significant reductions in mortality with implanted defibrillators. Two studies failed to demonstrate any benefit from pharmacologic antiarrhythmic therapy. The results of these studies in similar patient populations have erased any doubt regarding the ability of implanted defibrillators to reduce the risk of sudden death in patients with coronary disease. Our major challenge at this time is understanding how best to utilize this therapy in order to bring the benefit to the maximum number of patients while minimizing expense.
Cardiovascular Division, Department of Medicine, Brown Medical School, 2 Dudley Street, Suite 360, Providence, RI 02905, USA. Alfred_Buxton@Brown.edu
Alfred E
AE
Buxton
Kristin E
KE
Ellison
Malcolm M
MM
Kirk
Bryan
B
Frain
Charles
C
Koo
Gaurang
G
Gandhi
Sameh
S
Khouzam
D001145:Arrhythmias, Cardiac / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D003324:Coronary Artery Disease / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D006323:Heart Arrest / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D011322:Primary Prevention; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology; D014481:United States / Q000453:epidemiology