ICD Primary prevention trials

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TABLE 1. Overview of the Major Randomized Controlled Clinical Trials of ICD Therapy for Primary Prevention of Sudden Cardiac Death in Ischemic Cardiomyopathy
Study Inclusion Criteria Number Randomized Control Group Primary Point Main Finding
MADIT I35 Prior MI, EF ≤35%, NSVT, inducible and nonsuppressible VT on EPS, NYHA class I–III 196 Conventional therapy All-cause mortality 54% RRR in all-cause

mortality with ICD (P=0.009); absolute RR 23%

CABG-PATCH36 EF <35%, abnormal SAECG, elective CABG 900 Conventional therapy All-cause mortality No difference in all-cause mortality
MUSTT37 Prior MI, EF ≤40%, NSVT, inducible VT on EPS 704 EP-guided antiarrhythmic therapy or conventional therapy Cardiac arrest or death due to arrhythmia 60% RRR in all-cause mortality with ICD (P=0.001); absolute RR 31%
MADIT II39 Prior MI≤1 month, EF≤30%, NYHA class I–III 1232 Conventional therapy All-cause mortality 31% RRR in all-cause mortality with ICD (P=0.016); absolute RR 6%
DINAMIT38 Recent (6–40 days) MI, EF≤35%, abnormal HRV or elevated average HR on 24-h Holter, NYHA class I–III 674 Conventional therapy All-cause mortality No difference in all-cause mortality; 58% RRR from arrhythmia with ICD (P=0.009)
SCD-HeFT34 EF≤35%, (ischemic or nonischemic) NYHA class II–III 2521 Conventional therapy±amiodarone All-cause mortality 23% RRR in all-cause mortality with ICD (P=0.007); absolute RR 7%
EF indicates ejection fraction; NSVT, nonsustained VT; EPS, electrophysiological study; NYHA, New York Heart Association; RRR, relative risk reduction; RR, risk reduction; CABG, coronary artery bypass grafting; SAECG, signal-averaged ECG; HRV, heart rate variability; and HR, heart rate.