Related Experiment Video

Updated: Aug 11, 2026

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Prophylactic implantable cardioverter defibrillator therapy in dilated cardiomyopathy: impact of left ventricular

Beat A Schaer1, Peter Ammann, Christian Sticherling

  • 1Department of Cardiology, University Hospital, Petersgraben 4, 4031 Basel, Switzerland. bschaer@uhbs.ch

International Journal of Cardiology
|March 7, 2006
PubMed

Insights

Implantable cardioverter defibrillators (ICDs) in dilated cardiomyopathy (DCM) show benefits for secondary prevention. Primary prevention ICD use in DCM requires caution, especially for patients with left ventricular ejection fraction (LVEF) below 20%.

Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • The efficacy of implantable cardioverter defibrillators (ICDs) for primary prevention in dilated cardiomyopathy (DCM) remains uncertain, with prior trials showing no survival advantage over drug therapy.
  • Limited investigation exists on whether patients with severely impaired left ventricular ejection fraction (LVEF) benefit from ICD implantation for primary prevention.

Purpose of the Study:

  • To evaluate the outcomes of ICD implantation in patients with DCM, differentiating between secondary and primary prevention strategies.
  • To assess the impact of left ventricular ejection fraction (LVEF) on the effectiveness of ICDs in DCM patients.

Main Methods:

  • A cohort of 58 DCM patients who received an ICD between 1996 and 2003 were analyzed.
  • Patients were categorized into secondary prevention (Group A) and primary prevention (Group B).
  • Both groups were stratified based on LVEF: <20% and >20%.

Main Results:

  • No significant difference in mortality was observed between Group A (18%) and Group B (11%).
  • Group A showed significantly higher rates of adverse events (55% vs. 22%), any ICD intervention (48% vs. 17%), and life-threatening arrhythmia interventions (27% vs. 0%) compared to Group B.
  • In primary prevention (Group B), only patients with LVEF <20% experienced events, while LVEF was not predictive in Group A. A significant LVEF increase (>15%) occurred in 36% of patients, more frequently in Group B.

Conclusions:

  • ICD implantation for primary prevention in DCM should be approached cautiously.
  • Further research is necessary to determine the specific benefit of ICDs for DCM patients with LVEF <20%.
Abstract

More Related Videos

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System10:17

Real-Time Cardiac Mapping with a Noninvasive Imageless Electrocardiographic Imaging System

Published on: April 11, 2025

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation16:40

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation

Published on: February 28, 2012

Related Concept Videos

Cardiomyopathy II: Dilated Cardiomyopathy01:30

Cardiomyopathy II: Dilated Cardiomyopathy

Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
Cardiomyopathy IV: Restrictive Cardiomyopathy01:29

Cardiomyopathy IV: Restrictive Cardiomyopathy

Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular tachycardia.