Heart rhythm · 2025
Reassessing the need for primary prevention implantable cardioverter-defibrillators in contemporary patients with heart failure.
СтатьяОбзорПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Goldenberg Ilan, Ezekowitz Justin, Albert Christine, Alexis Jeffrey D, Anderson Lisa, Behr Elijah R, Daubert James, Di Palo Katherine E, Ellenbogen Kenneth A, Dzikowicz Dillon J, Hsich Eileen, Huang David T, Januzzi James L, Kutyifa Valentina, Lala Anuradha, Onwuanyi Anekwe, Piña Ileana L, Sandhu Roopinder K, Sears Samuel, Sroubek Jakub, Strawderman Robert, Zareba Wojciech, Butler Javed
Аннотация
The main function of the implantable cardioverter-defibrillator (ICD) is to protect against sudden cardiac death (SCD) due to ventricular tachyarrhythmia (VTA). Current guidelines provide a recommendation to implant a prophylactic ICD for the primary prevention of SCD in individuals having heart failure with reduced ejection fraction (HFrEF) who never experienced a previous sustained VTA. However, these recommendations are based on clinical trials conducted more than 20 years ago and may not be applicable to contemporary patients with HFrEF who have a lower arrhythmic risk as a result of advances in heart failure medical therapies. Thus, there is an unmet need for more appropriate selection of contemporary patients with HFrEF for a primary prevention ICD. In this article, we review data underlying the current clinical equipoise on the need for routine implantation of a primary prevention ICD in patients with HFrEF and the rationale for conducting clinical trials that aim to reassess the role of the ICD in this population.