Defibrillator Implantation in Patients with Nonischemic Systolic Heart Failure
The Danish Study is interesting because it shows that although the total mortality of pts with Nonischemic cardiomyopathy was not significantly different in the group with ICD as compared to the group without ICD particularly in the elderly population. The sudden cardiac death was still significantly lower in the ICD group. This suggests that the patients die most likely of other causes. It is important to mention that the vast majority of the population of the Danish Trial were Class II (53%) and Class III (45%) heart failure. We believe that in Europe this trial will trigger probably a revision of Current Guidelines and will reduce the use of ICD in the population described over 68 years of age particularly if comorbidities are present as other studies lead to this direction.
Køber L, et all. The New England Journal of Medecine 2016; 375: 1221-1230.