Abstract
Current guidelines for implantable cardioverter-defibrillator (ICD) implantation for patients after myocardial infarction (MI) recommend measurement of ejection fraction at least 40 days after the event for risk stratification. The rationale for not recommending ICD implantation in patients early after MI is based on the results of a series of trials. DINAMIT, 1 Hohnloser S.H. Kuck K.H. Dorian P. et al. Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. N Engl J Med. 2004; 351: 2481-2488 Crossref PubMed Scopus (1190) Google Scholar the IRIS trial, 2 Steinbeck G. Andresen D. Seidl K. et al. Defibrillator implantation early after myocardial infarction. N Engl J Med. 2009; 361: 1427-1436 Crossref PubMed Scopus (524) Google Scholar and an analysis of a subgroup of MADIT-II patients 3 Wilber D.J. Zareba W. Hall W.J. et al. Time dependence of mortality risk and defibrillator benefit after myocardial infarction. Circulation. 2004; 109: 1082-1084 Crossref PubMed Scopus (201) Google Scholar all found that although ICD implantation early post-MI reduced sudden deaths, it also resulted in an increase in nonsudden deaths and, therefore, failed to reduce total mortality. Electrophysiology-guided defibrillator implantation early after ST-elevation myocardial infarctionHeart RhythmVol. 7Issue 11PreviewSudden death risk is highest early after myocardial infarction (MI). Inducible ventricular tachycardia (VT) confers increased risk of spontaneous ventricular arrhythmias. Full-Text PDF Author Reply—ICD Implantation Early After Acute ST Elevation Myocardial InfarctionHeart RhythmVol. 8Issue 1PreviewAlthough arrhythmic risk is highest early post myocardial infarction (MI),1 there is no evidence of benefit from implantable cardioverter-defibrillator (ICD) implantation early post-MI.2,3 Based on current primary prevention ICD criteria, a large number of patients never experience therapy, and a significant proportion of patients are subjected to potential device-related morbidity, contributing to an increasing clinical and economic burden.4 Clearly, the challenge lies in creating a strategy for ICD implantation post-MI that both is critically timed and uses a risk stratification tool with the ability to select patients who are most likely to be rescued from arrhythmic death. Full-Text PDF
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
