A history of heart failure predicts arrhythmia treatment efficacy: Data from the Antiarrythmics versus Implantable Defibrillators (AVID) Study

Michael A. Brodsky, John McAnulty, Douglas P. Zipes, Christina Baessler, Alfred P. Hallstrom

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Background: In survivors of life-threatening ventricular tachycardia (VT), a history of CHF (HxCHF) before the VT episode may provide different prognostic information than their measured left ventricular ejection fraction (LVEF). Methods: We evaluated outcomes from patients in the AVID study. Patients were included in the study if they presented with ventricular fibrillation, VT with syncope or VT with hemodynamic compromise, and LVEF ≤40%. Treatment options included implantable cardioverter defibrillator (ICD) or antiarrhythmic drugs (AAD), usually amiodarone. Results: As expected, a HxCHF is associated with an increased and high risk of arrhythmic and nonarrhythmic death. However, an interaction was observed between arrhythmia treatment (ICD or AAD) and HxCHF status: the survival advantage with an ICD, as compared with AAD therapy, is largely restricted to HxCHF patients. Conclusions: The ICD is no better than AAD therapy in preventing arrhythmic death in patients with no HxCHF. In this data set, a HxCHF is somewhat more accurate in predicting prognosis and the response to therapy than a reduced LVEF.

Original languageEnglish (US)
Pages (from-to)724-730
Number of pages7
JournalAmerican Heart Journal
Volume152
Issue number4
DOIs
StatePublished - Oct 1 2006

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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