[Idiopathic dilated cardiomyopathy--an appraisal in 2005].
Patients who present with an impaired left ventricular (LV) function of nonischemic origin (EF < or = 35%), should first undergo intensified heart failure therapy with angiotensin-converting enzyme (ACE) inhibitors, beta-blockers and diuretics. If the impairment of LV function persists for 3-9 months despite adequate therapy, the implantation of a defibrillator (ICD) seems to be reasonable for the primary prevention of sudden cardiac death in these patients. If patients present with non-sustained ventricular tachycardias, ICD implantation and treatment with amiodarone are probably equally effective and better than mere heart failure therapy. In patients presenting with an indication for biventricular pacing, a biventricular ICD should be used.
Antz
Matthias
M
II. Medizinische Abteilung, Allgemeines Krankenhaus St. Georg, Lohmühlenstrasse 5, 20099 Hamburg. antz@uke.uni-hamburg.de
Bänsch
Dietmar
D
D002311:Cardiomyopathy, Dilated / Q000150:complications* / Q000628:therapy*; D016757:Death, Sudden, Cardiac / Q000209:etiology* / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000379:methods*; D006801:Humans; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D016896:Treatment Outcome