Abstract
The MADIT-II trial showed that in patients with a prior myocardial infarction and ejection fraction </=0.30, prophylactic implantation of a defibrillator improves survival with a 31% reduction in mortality during an average follow-up of 20 months. Electrophysiologic inducibility was positive in 36% of patients at the time of ICD implantation. Inducibility was associated with increased ICD utilization for ventricular tachycardia during long-term follow-up, and decreased utilization for ventricular fibrillation. These preliminary findings raise questions about the clinical usefulness of electrophysiologic testing as a risk stratifier in patients with advanced left ventricular dysfunction.
Publication types
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Clinical Trial
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Comparative Study
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Randomized Controlled Trial
MeSH terms
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Adult
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Aged
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Anti-Arrhythmia Agents / therapeutic use*
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Death, Sudden, Cardiac / prevention & control*
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Defibrillators, Implantable*
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Electrocardiography
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Female
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Follow-Up Studies
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Heart Function Tests
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Hemodynamics / physiology
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Humans
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Male
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Middle Aged
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Myocardial Infarction / complications*
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Myocardial Infarction / diagnosis
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Myocardial Infarction / mortality
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Probability
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Proportional Hazards Models
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Risk Assessment
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Risk Factors
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Severity of Illness Index
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Survival Analysis
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Tachycardia, Ventricular / diagnosis
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Tachycardia, Ventricular / etiology
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Tachycardia, Ventricular / mortality
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Tachycardia, Ventricular / therapy*
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Treatment Outcome
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Ventricular Dysfunction, Left / complications*
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Ventricular Dysfunction, Left / diagnosis
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Ventricular Dysfunction, Left / mortality