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MADIT-II: clinical implications
Arthur J Moss1, James Daubert, Wojciech Zareba
1Cardiology Unit, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA. heartajm@heart.rochester.edu
Abstract:
The MADIT-II trial showed that in patients with a prior myocardial infarction and ejection fraction =0.30, prophylactic implantation of a defibrillator improves survival with a 31% reduction in mortality during an average follow-up of 20 months. Electrophysiologic inducibility was positive in 36% of patients at the time of ICD implantation. Inducibility was associated with increased ICD utilization for ventricular tachycardia during long-term follow-up, and decreased utilization for ventricular fibrillation. These preliminary findings raise questions about the clinical usefulness of electrophysiologic testing as a risk stratifier in patients with advanced left ventricular dysfunction.