Implications and problems of the Sudden Cardiac Death in Heart Failure Trial.
Evaluation of: Bardy GH, Lee KL, Mark DB et al.: Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N. Engl. J. Med. 352, 225-237 (2005). In the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT), implantable cardioverter defibrillators (ICDs) reduced mortality by 23% compared with placebo patients with moderate-to-severe heart failure and impaired left ventricular function (ejection fraction < 35%), who were treated with conventional therapy for congestive heart failure. These results did not vary between the ischemic and non-ischemic patients, and a similar effect was observed in both patient groups with Class II and III heart failure. This study confirmed that ICD therapy is the standard of care for patients with a low left ventricular function and heart failure. Whether adjunctive drug therapy or newly developed devices, such as dual chamber ICDs, or cardiac resynchronization therapy can improve the prognosis or quality of life in these patients who are eligible for ICDs, is under consideration.
National Cardiovascular Center, Division of Cardiology, Department of Internal Medicine, 5-7-1 Fujishiro-dai, Suita, Osaka 565-8565, Japan.
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Shimizu
Kazuhiro
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Satomi