title: Secondary prevention in heart failure.
abstract: Although most recent investigations into sudden cardiac death prevention in heart failure patients have been focused on primary prevention, secondary indications for defibrillators and medical therapy remain vitally important in this complex patient group. Antiarrhythmic therapy is currently used primarily as adjuvant therapy to implantable defibrillators. Secondary prophylaxis defibrillator trials have shown clear benefit in preventing recurrent sudden cardiac death, despite concern over inappropriate shocks and the potential detrimental effects of appropriate shocks. Device programming for secondary prophylaxis can help ameliorate these issues. This article discusses these issues as well as the continued underuse of defibrillators in specific populations.
authors: Electrophysiology Section, Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, 9 Founders Pavilion, 3400 Spruce Street, Philadelphia, PA 19104, USA.
authors: Melissa R
authors: MR
authors: Robinson
authors: Andrew E
authors: AE
authors: Epstein
authors: David J
authors: DJ
authors: Callans
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D017147:Defibrillators, Implantable; D006333:Heart Failure / Q000188:drug therapy / Q000517:prevention & control* / Q000628:therapy; D006801:Humans; D055502:Secondary Prevention
chemical_list: D000889:Anti-Arrhythmia Agents