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Implantable cardioverter defibrillator in non-ischemic cardiomyopathy: a meta-analysis of randomized controlled

Ahmad Masri1, Muhammad Hammadah2, Evan Adelstein1

  • 1Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Cardiovascular Diagnosis and Therapy
|September 12, 2017
PubMed

Insights

Implantable cardioverter defibrillators (ICDs) significantly reduce sudden cardiac death (SCD) and all-cause mortality in non-ischemic cardiomyopathy (NICM) patients. This meta-analysis confirms ICD therapy

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Sudden cardiac death (SCD) is a major concern in non-ischemic cardiomyopathy (NICM).
  • Implantable cardioverter defibrillators (ICDs) are used for primary prevention of SCD in NICM.
  • Previous studies yielded conflicting results on ICD efficacy in NICM.

Purpose of the Study:

  • To conduct an updated meta-analysis on the impact of ICDs on patient outcomes in NICM.
  • To evaluate the effect of ICDs on all-cause mortality, SCD, and cardiac mortality in NICM patients.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials (RCTs).
  • Searched PubMed, EMBASE, and Cochrane databases for relevant RCTs.
  • Calculated Mantel-Haenszel risk ratios (RR) using random-effects models.

Main Results:

  • Five RCTs involving 2,867 patients were analyzed.
  • ICD use showed a 24% relative risk reduction (RRR) in all-cause mortality (P=0.002).
  • ICD use demonstrated a 60% RRR in SCD (P=0.03) but no significant reduction in cardiac mortality (P=0.39).

Conclusions:

  • ICD therapy is effective in reducing all-cause mortality in NICM patients.
  • ICD therapy significantly lowers the risk of sudden cardiac death in NICM.
  • The findings support the use of ICDs for primary prevention in selected NICM patients.
Abstract

Keywords:
Deathimplantable defibrillatorsmeta-analysisnon-ischemic cardiomyopathy (NICM)randomized controlled trial (RCT)

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