PMID- 11899573
OWN - NLM
STAT- MEDLINE
DCOM- 20021001
LR  - 20071115
IS  - 1129-4728 (Print)
IS  - 1129-4728 (Linking)
VI  - 3
IP  - 1
DP  - 2002 Jan
TI  - [In patients with heart failure, do implantable cardioverter-defibrillators delay 
      death or save lives?].
PG  - 36-44
AB  - Heart failure is one of the most important public health problems in western 
      countries because of its frequent association with cardiac death and with 
      rehospitalization. Patients with heart failure generally die of sudden arrhythmic 
      death (SD) and progressive pump failure with a SD incidence inversely related to 
      the severity of the underlying heart disease. SD occurs approximately in one half 
      of the patients in New York Heart Association (NYHA) functional classes II-II/III 
      and in one third of those in NYHA classes III/IV-IV, respectively. In the last 
      decade, numerous studies have shown that the automatic implantable 
      cardioverter-defibrillator (ICD) significantly reduces the incidence of SD in 
      those patients who are identified as being at risk. Unfortunately, little is 
      known on whether the ICD actually prolongs the survival of the subgroup of 
      patients with most severe heart failure. The main reasons for such a paucity of 
      information are the small number of available studies, the unavailability of 
      randomized and controlled investigations and the difficulty in comparing the 
      results of such studies owing to the lack of homogeneity. In patients with severe 
      heart failure, both the perioperative mortality and morbidity related to 
      transvenous ICD implantation are similar to those of patient subgroups with 
      moderate or slight heart failure. The defibrillation threshold at implantation 
      and the frequency of intractable ventricular arrhythmias during follow-up (2% of 
      all ICD implantations) are slightly higher than in the patient subgroup with 
      moderate or no heart failure. In the patient subgroup with severe heart failure 
      or with a very poor left ventricular function, ICD implantation is unable to 
      prolong the 1- and 2-year survival despite a clear reduction in the incidence of 
      SD. On the other hand, in the patient subgroup with moderate left ventricular 
      dysfunction, ICD implantation prolongs survival and reduces the incidence of SD. 
      No information is available regarding the primary prevention of SD in patients 
      with heart failure.
FAU - Berisso, Massimo Zoni
AU  - Berisso MZ
AD  - Divisione di Cardiologia E.O. Ospedali Galliera Via Volta, 8 16128 Genova. 
      zoni.berisso@galliera.it
FAU - Delfino, Luigi
AU  - Delfino L
FAU - Viani, Stefano
AU  - Viani S
LA  - ita
PT  - English Abstract
PT  - Journal Article
PT  - Review
TT  - Nei pazienti con insufficienza cardiaca il cardioverter-defibrillatore 
      impiantabile ritarda la morte o salva la vita?
PL  - Italy
TA  - Ital Heart J Suppl
JT  - Italian heart journal. Supplement : official journal of the Italian Federation of 
      Cardiology
JID - 101223651
SB  - IM
MH  - Death, Sudden
MH  - *Defibrillators, Implantable/trends
MH  - Forecasting
MH  - Heart Failure/complications/*mortality/*therapy
MH  - Humans
MH  - Severity of Illness Index
MH  - Survival Rate
MH  - Time Factors
RF  - 71
EDAT- 2002/03/20 10:00
MHDA- 2002/10/03 04:00
CRDT- 2002/03/20 10:00
PHST- 2002/03/20 10:00 [pubmed]
PHST- 2002/10/03 04:00 [medline]
PHST- 2002/03/20 10:00 [entrez]
PST - ppublish
SO  - Ital Heart J Suppl. 2002 Jan;3(1):36-44.