![]() ![]() Information about longterm prognosis after ICD therapy in such patients is limited. conclusions In patients with NYHA class II or III CHF and LVEF of 35 percent or less, amiodarone has no favorable effect on survival, whereas single-lead, shock-only ICD therapy reduces overall mortality by 23 percent.read more read lessĪbstract: Background Patients with heart failure who receive an implantable cardioverter–defibrillator (ICD) for primary prevention (i.e., prevention of a first life-threatening arrhythmic event) may later receive therapeutic shocks from the ICD. Results did not vary according to either ischemic or nonischemic causes of CHF, but they did vary according to the NYHA class. ![]() ![]() As compared with placebo, amiodarone was associated with a similar risk of death (hazard ratio, 1.06 97.5 percent confidence interval, 0.86 to 1.30 P=0.53) and ICD therapy was associated with a decreased risk of death of 23 percent (0.77 97.5 percent confidence interval, 0.62 to 0.96 P=0.007) and an absolute decrease in mortality of 7.2 percentage points after five years in the overall population. There were 244 deaths (29 percent) in the placebo group, 240 (28 percent) in the amiodarone group, and 182 (22 percent) in the ICD group. The cause of CHF was ischemic in 52 percent and nonischemic in 48 percent. results The median LVEF in patients was 25 percent 70 percent were in NYHA class II, and 30 percent were in class III CHF. The primary end point was death from any cause. Placebo and amiodarone were administered in a double-blind fashion. methods We randomly assigned 2521 patients with New York Heart Association (NYHA) class II or III CHF and a left ventricular ejection fraction (LVEF) of 35 percent or less to conventional therapy for CHF plus placebo (847 patients), conventional therapy plus amiodarone (845 patients), or conventional therapy plus a conservatively programmed, shockonly, single-lead ICD (829 patients). Treatment with amiodarone or an implantable cardioverter–defibrillator (ICD) has been proposed to improve the prognosis in such patients. Abstract: background Sudden death from cardiac causes remains a leading cause of death among patients with congestive heart failure (CHF). ![]()
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