Skip to main content
Journal cover image

Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators.

Publication ,  Journal Article
Moss, AJ; Hall, WJ; Cannom, DS; Daubert, JP; Higgins, SL; Klein, H; Levine, JH; Saksena, S; Waldo, AL; Wilber, D; Brown, MW; Heo, M
Published in: N Engl J Med
December 26, 1996

BACKGROUND: Unsustained ventricular tachycardia in patients with previous myocardial infarction and left ventricular dysfunction is associated with a two-year mortality rate of about 30 percent. We studied whether prophylactic therapy with an implanted cardioverter-defibrillator, as compared with conventional medical therapy, would improve survival in this high-risk group of patients. METHODS: Over the course of five years, 196 patients in New York Heart Association functional class I, II, or III with prior myocardial infarction; a left ventricular ejection fraction < or = 0.35; a documented episode of asymptomatic unsustained ventricular tachycardia; and inducible, nonsuppressible ventricular tachyarrhythmia on electrophysiologic study were randomly assigned to receive an implanted defibrillator (n = 95) or conventional medical therapy (n=101). We used a two-sided sequential design with death from any cause as the end point. RESULTS: The base-line characteristics of the two treatment groups were similar. During an average follow-up of 27 months, there were 15 deaths in the defibrillator group (11 from cardiac causes) and 39 deaths in the conventional-therapy group (27 from cardiac causes) (hazard ratio for overall mortality, 0.46; 95 percent confidence interval, 0.26 to 0.82; P=0.009). There was no evidence that amiodarone, beta-blockers, or any other antiarrhythmic therapy had a significant influence on the observed hazard ratio. CONCLUSIONS: In patients with a prior myocardial infarction who are at high risk for ventricular tachyarrhythmia, prophylactic therapy with an implanted defibrillator leads to improved survival as compared with conventional medical therapy.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

N Engl J Med

DOI

ISSN

0028-4793

Publication Date

December 26, 1996

Volume

335

Issue

26

Start / End Page

1933 / 1940

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Tachycardia, Ventricular
  • Survival Analysis
  • Risk Factors
  • Proportional Hazards Models
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • General & Internal Medicine
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Moss, A. J., Hall, W. J., Cannom, D. S., Daubert, J. P., Higgins, S. L., Klein, H., … Heo, M. (1996). Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators. N Engl J Med, 335(26), 1933–1940. https://doi.org/10.1056/NEJM199612263352601
Moss, A. J., W. J. Hall, D. S. Cannom, J. P. Daubert, S. L. Higgins, H. Klein, J. H. Levine, et al. “Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators.N Engl J Med 335, no. 26 (December 26, 1996): 1933–40. https://doi.org/10.1056/NEJM199612263352601.
Moss AJ, Hall WJ, Cannom DS, Daubert JP, Higgins SL, Klein H, Levine JH, Saksena S, Waldo AL, Wilber D, Brown MW, Heo M. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators. N Engl J Med. 1996 Dec 26;335(26):1933–1940.
Journal cover image

Published In

N Engl J Med

DOI

ISSN

0028-4793

Publication Date

December 26, 1996

Volume

335

Issue

26

Start / End Page

1933 / 1940

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Tachycardia, Ventricular
  • Survival Analysis
  • Risk Factors
  • Proportional Hazards Models
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • General & Internal Medicine