Originally published in Insidermedicine
Implanting a cardioverter-defibrillator (ICD) is no better at saving lives than simply providing optimal medical therapy for individuals who suffer damage to the heart from a heart attack, according to research published in the latest issue of the New England Journal of Medicine.
Here is some information on the ICD:
• It is a small device that is placed inside the chest or abdomen and produces an electrical pulse or shock to the heart when it starts to beat irregularly
• It is similar to a pacemaker but can deliver a more potent electrical shock
• It is used in individuals at risk of developing life-threatening abnormal heart rhythms, some of which can result in sudden cardiac death
Researchers representing the IRIS investigators randomly assigned nearly 800 individuals to be implanted with an ICD or receive optimal medical therapy during the 5 to 31 days following a heart attack. The study participants had several clinical features that indicated that their hearts were damaged from the attacks and that they were at a particularly high risk of dying during the following weeks and months.
During a follow-up period of about three years, about a quarter of the patients died in each group. While death rates were similar in both groups, what they died of varied by the type of treatment they received. Those who received medical therapy were more likely to die of sudden cardiac death, while those with the ICD were more likely to die of cardiac causes that were not sudden.
Today’s research suggests that implanting an ICD in high risk-patients who experience a heart attack will not help them live longer than simply giving them the best available medical treatment.
