Maximizing survival benefit with primary prevention implantable cardioverter-defibrillator therapy in a heart failure population.
BACKGROUND: Although implantable cardioverter-defibrillator (ICD) therapy reduces mortality in moderately symptomatic heart failure patients with an ejection fraction 20%), no benefit of ICD treatment was seen. Projected over each patient's predicted lifespan, ICD treatment added 6.3, 4.1, 3.0, 1.9, and 0.2 additional years of life in the lowest- to highest-risk groups, respectively. CONCLUSIONS: A clinical risk prediction model identified subsets of moderately symptomatic heart failure patients in SCD-HeFT in whom single-lead ICD therapy was of no benefit and other subsets in which benefit was substantial.
Levy, WC; Lee, KL; Hellkamp, AS; Poole, JE; Mozaffarian, D; Linker, DT; Maggioni, AP; Anand, I; Poole-Wilson, PA; Fishbein, DP; Johnson, G; Anderson, J; Mark, DB; Bardy, GH
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