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Related Experiment Videos

Can implantable defibrillators reduce non-arrhythmic mortality?

S Nisam1

  • 1CPI/Guidant. SNISAM@Guidant.com

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
|February 23, 1999
PubMed
Summary

Implantable Cardioverter Defibrillators (ICD) may reduce non-arrhythmic deaths, possibly by preventing long-term cardiac damage from untreated ventricular tachycardia. Further research is needed to confirm this effect and guide therapy choices.

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Is prophylaxis the best use of the ICD?

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A prophylactic ICD? Who are the patients? What is the device?

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology·2001
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Primary prevention of sudden cardiac death with implantable cardioverter defibrillators: lessons learned from MADIT and MUSTT.

Pacing and clinical electrophysiology : PACE·2001
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Perspectives: does amiodarone increase non-sudden deaths? If so, why?

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The utilization of the implantable defibrillator--a European enigma.

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Prophylactic implantable cardioverter defibrillator trials: MUSTT, MADIT, and beyond. Multicenter Unsustained Tachycardia Trial. Multicenter Automatic Defibrillator Implantation Trial.

The American journal of cardiology·2000

Area of Science:

  • Cardiology
  • Medical Devices
  • Clinical Research

Background:

  • Observations suggest Implantable Cardioverter Defibrillators (ICDs) reduce not only sudden cardiac deaths but also non-arrhythmic mortality.
  • This effect is not attributable to patient selection bias, indicating a potential direct impact of ICD therapy.
  • The comparison involves two distinct treatment strategies: ICD implantation versus antiarrhythmic drug therapy.

Purpose of the Study:

  • To explore the potential mechanisms behind the observed reduction in non-arrhythmic mortality in patients treated with ICDs.
  • To investigate whether antiarrhythmic drugs, under certain conditions, may contribute to non-arrhythmic deaths.
  • To understand the long-term cardiac effects of prolonged ventricular tachycardia episodes managed with different therapeutic approaches.

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Main Methods:

  • Comparative analysis of mortality data between patients receiving ICDs and those treated with antiarrhythmic drugs.
  • Review of existing studies and literature to identify potential explanations for the observed phenomenon.
  • Hypothesizing the impact of prolonged ventricular tachycardia on cardiac function versus rapid termination by ICD.

Main Results:

  • ICDs appear to reduce non-arrhythmic mortality, challenging conventional understanding.
  • A potential contributing factor to non-arrhythmic deaths may be the use of antiarrhythmic drugs.
  • Prolonged ventricular tachycardia episodes may have detrimental long-term effects on cardiac function compared to ICD intervention.

Conclusions:

  • The observed reduction in non-arrhythmic deaths associated with ICDs warrants further investigation.
  • Understanding the specific mechanisms may refine patient selection for ICD therapy versus antiarrhythmic drugs.
  • Further research is crucial to elucidate this 'curious mode of death' and optimize therapeutic strategies.