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Efficacy of Sacubitril/Valsartan Among Heart Failure Individuals With Implanted Cardiac Defibrillators: A Systematic

Hila Asham1, Shaghayegh Salehian1, Afshin Gharekhani1

  • 1Faculty of Pharmacy Tabriz University of Medical Sciences Tabriz Iran.

Journal of Arrhythmia
|December 18, 2025
PubMed

Insights

Sacubitril/valsartan significantly reduced implantable cardioverter-defibrillator (ICD) shocks and non-sustained ventricular tachycardia (NSVT) duration in heart failure patients. Further research is needed to confirm its antiarrhythmic benefits in this population.

Area of Science:

  • Cardiology
  • Pharmacology
  • Medical Devices

Background:

  • Sacubitril/valsartan has demonstrated antiarrhythmic effects in heart failure (HF).
  • The impact of sacubitril/valsartan on ventricular arrhythmias in patients with implantable cardioverter-defibrillators (ICDs) requires further investigation.

Purpose of the Study:

  • To systematically review and meta-analyze the effects of sacubitril/valsartan on ventricular arrhythmias in patients with HF and ICDs.

Main Methods:

  • Systematic search of PubMed, Embase, and Cochrane Library databases.
  • Meta-analysis of four paired observational cohort studies involving 397 patients.
  • Analysis of binary and continuous variables using random-effects models.

Main Results:

  • Sacubitril/valsartan significantly reduced the incidence of ICD shocks (OR, 0.33) and appropriate ICD shocks (OR, 0.21).
  • A significant reduction in non-sustained ventricular tachycardia (NSVT) duration (OR, -1.86) and biventricular pacing < 90% (OR, 0.15) was observed.
  • No significant association was found with reduced rates of ventricular arrhythmia, sustained ventricular tachycardia (SVT), inappropriate ICD shocks, premature ventricular contractions per hour (PVC/h), or improved left ventricular ejection fraction (LVEF).

Conclusions:

  • Sacubitril/valsartan may offer potential antiarrhythmic benefits for heart failure patients with cardiac defibrillators.
  • Further investigations are warranted to confirm these antiarrhythmic effects in this specific patient population.
Abstract

Keywords:
cardiac defibrillatorheart failuremeta‐analysissacubitril/valsartansystematic reviewventricular tachycardia

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