TY - JOUR
T1 - Role of implantable cardioverter defibrillator in non-ischemic cardiomyopathy
T2 - a systematic review and meta-analysis of prospective randomized clinical trials
AU - Romero, Jorge E.
AU - Chaudhary, Rahul
AU - Garg, Jalaj
AU - Lupercio, Florentino
AU - Shah, Neeraj
AU - Gupta, Rahul
AU - Nazir, Talha
AU - Bozorgnia, Babak
AU - Natale, Andrea
AU - Di Biase, Luigi
PY - 2017/7/3
Y1 - 2017/7/3
N2 - Introduction: A mortality benefit in patients with implantable cardioverter defibrillator (ICD) in ischemic cardiomyopathy is well established. However, the benefit of ICD implantation in non-ischemic cardiomyopathy (NICM) on total mortality remains uncertain. We performed a systematic review and meta-analysis of randomized controlled trials (RCT) evaluating the role of primary prevention ICD in NICM patients. Methods: We performed a systematic review on PubMed, The Cochrane Library, EMBASE, EBSCO, Web of Science, and CINAHL databases from the inception through February 2017 to identify RCT evaluating the role of ICD in NICM patients. Mantel-Haenszel risk ratio (RR) fixed effects model was used to summarize data across treatment arms. If heterogeneity (I2) ≥25, random effects model was used instead. Results: We analyzed a total of 2573 patients from five RCTs comparing ICD with medical therapy in patients with NICM. The mean follow up for the trials was 48 ± 22 months. There was a significant reduction in (a) all-cause mortality (RR 0.84, 95% CI 0.71–0.99, p = 0.03) and (b) sudden cardiac death (RR 0.47, 95% CI 0.30–0.73, p < 0.001) in ICD group versus medical therapy. Conclusion: Our analysis demonstrates that the use of ICD for primary prevention is associated with a reduction in all-cause mortality and SCD in patients with NICM.
AB - Introduction: A mortality benefit in patients with implantable cardioverter defibrillator (ICD) in ischemic cardiomyopathy is well established. However, the benefit of ICD implantation in non-ischemic cardiomyopathy (NICM) on total mortality remains uncertain. We performed a systematic review and meta-analysis of randomized controlled trials (RCT) evaluating the role of primary prevention ICD in NICM patients. Methods: We performed a systematic review on PubMed, The Cochrane Library, EMBASE, EBSCO, Web of Science, and CINAHL databases from the inception through February 2017 to identify RCT evaluating the role of ICD in NICM patients. Mantel-Haenszel risk ratio (RR) fixed effects model was used to summarize data across treatment arms. If heterogeneity (I2) ≥25, random effects model was used instead. Results: We analyzed a total of 2573 patients from five RCTs comparing ICD with medical therapy in patients with NICM. The mean follow up for the trials was 48 ± 22 months. There was a significant reduction in (a) all-cause mortality (RR 0.84, 95% CI 0.71–0.99, p = 0.03) and (b) sudden cardiac death (RR 0.47, 95% CI 0.30–0.73, p < 0.001) in ICD group versus medical therapy. Conclusion: Our analysis demonstrates that the use of ICD for primary prevention is associated with a reduction in all-cause mortality and SCD in patients with NICM.
KW - Implantable cardiac defibrillator
KW - Non-ischemic cardiomyopathy
KW - Sudden cardiac death
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U2 - 10.1007/s10840-017-0260-8
DO - 10.1007/s10840-017-0260-8
M3 - Article
C2 - 28674918
AN - SCOPUS:85021813093
SN - 1383-875X
SP - 1
EP - 8
JO - Journal of Interventional Cardiac Electrophysiology
JF - Journal of Interventional Cardiac Electrophysiology
ER -