PMID- 37255904
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230601
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 4
DP  - 2023 Apr
TI  - The Relevance of Preventive Implantable Cardioverter-Defibrillators (ICDs) in 
      Non-Ischemic Cardiomyopathy in the Presence of Effective Quadruple Therapy for 
      Heart Failure: A Review of Contemporary Medical Literature.
PG  - e38268
LID - 10.7759/cureus.38268 [doi]
LID - e38268
AB  - Cardiomyopathy is a disease of the cardiomyocytes that affects their structural 
      function, leading to heart failure (HF). Non-ischemic cardiomyopathy (NICM) 
      includes a subtype of dilated cardiomyopathy (DCM), restrictive cardiomyopathy 
      (RCM), and hypertrophic cardiomyopathy (HCM). These types of cardiomyopathies 
      have no coronary artery vessel involvement. The most common cause of NICM is DCM. 
      In the ischemic cardiomyopathy (ICM) subtype, the utilization of implantable 
      cardioverter-defibrillators (ICDs) has been effective in the prevention of sudden 
      cardiac death (SCD). However, the relevance of ICDs in patients with NICM having 
      an ejection fraction (EF) </=35%, who are also receiving effective quadruple 
      therapy (i.e., angiotensin-converting enzyme (ACE) inhibitors or angiotensin 
      receptor blockers (ARB), beta-blockers, mineralocorticoid receptor antagonists, 
      and sodium-glucose cotransporter-2 (SGLT2) inhibitors) for HF has been a topic of 
      debate. The purpose of this review is to analyze the benefits of preventive ICDs 
      in NICM patients on adequate quadruple therapy for HF. The current guidelines 
      recommend ICD implantation in patients with NICM who have a left ventricular 
      ejection fraction of </=35%, come under the New York Heart Association (NYHA) class 
      II or III, and are in sinus rhythm with optimal medical therapy. The evidence 
      supporting this recommendation is limited. Numerous clinical studies and 
      meta-analyses have been conducted to look into this issue. While some have 
      discovered a substantial decrease in mortality with the implantation of an ICD in 
      patients with NICM, others have not found significant changes. Thereby, further 
      investigations are required to define the function of ICDs in this population.
CI  - Copyright (c) 2023, Obi et al.
FAU - Obi, Mukosolu F
AU  - Obi MF
AD  - Internal Medicine, Wyckoff Heights Medical Center, New York City, USA.
FAU - Namireddy, Vikhyath
AU  - Namireddy V
AD  - Medicine, St. George's University School of Medicine, True Blue, GRD.
FAU - Reinberg Palmar, Maria A
AU  - Reinberg Palmar MA
AD  - Medicine, St. George's University School of Medicine, True Blue, GRD.
FAU - Sharma, Manjari
AU  - Sharma M
AD  - Internal Medicine, Wyckoff Heights Medical Center, New York City, USA.
FAU - Gulas, Jennifer A
AU  - Gulas JA
AD  - Internal Medicine, Wyckoff Heights Medical Center, New York City, USA.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20230428
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10225273
OTO - NOTNLM
OT  - cardiac sudden death
OT  - guideline directed medical therapy
OT  - heart failure
OT  - implantable cardioverter-defibrillator (icd)
OT  - ischemic dilated cardiomyopathy
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/05/31 13:12
MHDA- 2023/05/31 13:13
PMCR- 2023/04/28
CRDT- 2023/05/31 10:30
PHST- 2023/04/28 00:00 [accepted]
PHST- 2023/05/31 13:13 [medline]
PHST- 2023/05/31 13:12 [pubmed]
PHST- 2023/05/31 10:30 [entrez]
PHST- 2023/04/28 00:00 [pmc-release]
AID - 10.7759/cureus.38268 [doi]
PST - epublish
SO  - Cureus. 2023 Apr 28;15(4):e38268. doi: 10.7759/cureus.38268. eCollection 2023 
      Apr.