title: Implantable cardiac defibrillators and sudden death in recent onset nonischemic cardiomyopathy: results from IMAC2.
abstract: BACKGROUND
  Given the potential for recovery in recent onset nonischemic cardiomyopathy (ROCM), the timing and need for implantable cardioverter-defibrillator (ICDs) remains controversial. We examined the utilization of ICDs and the impact on survival for subjects with ROCM.
  
  
  RESULTS
  An National Heart, Lung, and Blood Institute sponsored registry enrolled 373 subjects with ROCM, all with a left ventricular ejection fraction (LVEF) ≤0.40 and ≤6 months of symptoms. The mean age was 45 ± 14 years, 38% were female, 21% black, 75% New York Heart Association II/III, and the mean LVEF was 0.24 ± 0.08. Survival was comparable for subjects with an ICD within 1 month of entry (n = 43, 1/2/3 year % survival = 97/97/92) and those with no ICD at 1 month (n = 330, % survival = 98/97/95, P = .30) and between those with and without an ICD at 6 months (ICD, n = 73, 1/2/3 year % survival = 98/98/95; no ICD, n = 300, % survival = 98/96/95, P = .95). There were only 6 sudden cardiac deaths (SCD) noted (% survival free from SCD = 99/98/97) and these occurred in 1.9% of subjects without ICD and 0.9% of those with a device (P = .50).
  
  
  CONCLUSIONS
  In a multicenter cohort of ROCM the risk of SCD was low at 1% per year. Early ICD placement did not impact survival and can be deferred while assessing potential for myocardial recovery.
authors.affiliation: Jewish General Hospital, McGill University, Montreal, Canada.
authors.forename: Richard
authors.initials: R
authors.lastname: Sheppard
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Mather
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Alexis
authors.forename: Randall C
authors.initials: RC
authors.lastname: Starling
authors.forename: John P
authors.initials: JP
authors.lastname: Boehmer
authors.forename: Vinay
authors.initials: V
authors.lastname: Thohan
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Pauly
authors.forename: David W
authors.initials: DW
authors.lastname: Markham
authors.forename: Mark
authors.initials: M
authors.lastname: Zucker
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Kip
authors.forename: Dennis M
authors.initials: DM
authors.lastname: McNamara
mesh_terms: D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control*; D009202:Cardiomyopathies / Q000453:epidemiology / Q000517:prevention & control*; D016757:Death, Sudden, Cardiac / Q000517:prevention & control*; D017147:Defibrillators, Implantable; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012042:Registries; D013997:Time Factors; D014481:United States / Q000453:epidemiology