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NEJM provides
two ICD studies

Defibrillator Study Leads to Shocking Conclusion

by Barbara Kram, Editor
An article in today's New England Journal of Medicine provides results from the study "Prognostic Importance of Defibrillator Shocks in Patients with Heart Failure."

Lead investigator Jeanne E. Poole, M.D., University of Washington in Seattle, and colleagues studied heart failure patients with implantable cardioverter-defibrillators (ICDs), devices that shock the heart back into rhythm. Some of the shocks were considered appropriate but others inappropriate. In both types of cases the ICD shocks increased the risk of death according to an analysis of study data.

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"Among patients with heart failure in whom an ICD is implanted for primary prevention, those who receive shocks for any arrhythmia have a substantially higher risk of death than similar patients who do not receive such shocks," the study abstract concluded.

A related study in the same journal finds that ICD patients enjoy favorable quality of life. Read about it at http://www.dotmed.com/news/story/6954.

AdvaMed Response

ICDs can save lives, according to David Nexon, senior executive vice president of the Advanced Medical Technology Association (AdvaMed), an organization of medical technology companies.

"It is important to put the results of the study within the context of the significant overall patient benefit of implantable-cardioverter defibrillators (ICDs). First and foremost, ICDs are incredibly successful in achieving their primary purpose: saving lives. ICDs are 98 percent effective in treating dangerous ventricular arrhythmias that can lead to sudden cardiac arrest. The SCD-HeFT data set used by the study's authors showed that ICD therapy significantly reduced all-cause mortality by 23 percent compared to placebo, and ICDs were superior to drug therapy. Several other studies also have demonstrated the benefits of ICD therapy," he said in a statement. "Patients should discuss any concerns they may have arising from this study with their physician."

Read the New England Journal of Medicine (9/4/08) study abstract (Volume 359:1009-1017; September 4, 2008; Number 10).



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