Impact of implantable cardioverter-defibrillators on prognosis of cardiac arrest survivors. A continuing controversy.

Adler, Stuart W.; Remole, Stephen; Benditt, David G.

doi:10.1161/01.cir.88.3.1348

Cited by 4 publications

(2 citation statements)

References 16 publications

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“…Conversely, the most frequently cited reason for not implanting an ICD among patients on drug for >1 year was physician recommendation. In view of the trial results and the uncertainty prior to AVID regarding the impact of ICD therapy on mortality, 4,5 it is not surprising that many physicians recommended continuation of drug therapy rather than ICD therapy in patients who had been stable for more than 1 year.…”

Section: Discussionmentioning

confidence: 99%

Factors Determining ICD Implantation in Drug Therapy Patients After Termination of Antiarrythmics Versus Implantable Defibrillators Trial

Klein

Schron

Renfroe

et al. 2003

Pacing Clinical Electrophis

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Because of a significant survival benefit in the defibrillator arm of the Antiarrhythmics versus Implantable Defibrillator (AVID) Trial, patients in the antiarrhythmic drug (AAD) arm were advised to undergo ICD implantation. Despite this recommendation, ICD implantation in AAD patients was variable, with a large number of patients not undergoing ICD implantation. Patients were grouped by those who had been on AAD < 1 year (n = 111) and those on AAD > 1 year (n = 223). Multiple clinical and socioeconomic factors were evaluated to identify those who might be associated with a decision to implant an ICD. The primary reason for patients not undergoing ICD implantation was collected, as well as reasons for a delayed implantation, occurring later than 3 months from study termination. Of 111 patients on AAD for less than 1 year, 53 received an ICD within 3 months compared to 40/223 patients on AAD for more than 1 year (P < 0.001). Patient refusal was the most common reason to not implant an ICD in patients on drug < 1 year; physician recommendation against implantation was the most common in patients on drug > 1 year. Multivariate analysis showed ICD recipients on AAD < 1 year were more likely to be working and have a history of myocardial infarction (MI), while those on AAD > 1 year were more likely to be working, have a history of MI and ventricular fibrillation, and less likely to have experienced syncope, as compared to those who did not get an ICD. Having private insurance may have played a role in younger patients receiving an ICD.

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Section: Discussionmentioning

confidence: 99%

Factors Determining ICD Implantation in Drug Therapy Patients After Termination of Antiarrythmics Versus Implantable Defibrillators Trial

Klein

Schron

Renfroe

et al. 2003

Pacing Clinical Electrophis

View full text Add to dashboard Cite

show abstract

“…32 33 Others have reported that the outcomes of patients with implantable devices were not dramatically different from those of patients treated with other methods, mainly guided by responses to electrophysiological testing, and therefore argued that prospective studies would be ethically justified 34. A placebo controlled study in patients who have survived a cardiac arrest cannot be justified, but several large studies are now under way to compare implantable devices with drug treatment, particularly amiodarone, sotalol, and ß blockade 28 29 30 35. In addition, implantable defibrillators are being compared with no antiarrhythmic treatment in patients who are at high risk of sudden death because they have left ventricular dysfunction and non-sustained ventricular arrhythmias.…”

Section: Arrhythmias and Implantable Cardioverterdefibrillatorsmentioning

confidence: 99%

Recent Advances: Cardiology II: Treatment of heart failure and atrial fibrillation and arrhythmias

McMurray

Rankin²

1994

BMJ

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Antiarrhythmic drugs versus implantable defibrillators: The need for a randomized controlled study

Greene

1994

American Heart Journal

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Impact of implantable cardioverter-defibrillators on prognosis of cardiac arrest survivors. A continuing controversy.

Cited by 4 publications

References 16 publications

Factors Determining ICD Implantation in Drug Therapy Patients After Termination of Antiarrythmics Versus Implantable Defibrillators Trial

Factors Determining ICD Implantation in Drug Therapy Patients After Termination of Antiarrythmics Versus Implantable Defibrillators Trial

Recent Advances: Cardiology II: Treatment of heart failure and atrial fibrillation and arrhythmias

Antiarrhythmic drugs versus implantable defibrillators: The need for a randomized controlled study

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