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Research In Brief

This article was originally published in The Gray Sheet

Executive Summary

Primary prevention ICD: About one-fifth of the so-called SCD-HeFT population, heart failure patients indicated for a primary prevention implantable defibrillator, do not benefit from ICD therapy because their heart failure is too advanced, according to the results of a study by Wayne C. Levy, M.D., University of Washington, et al. that appears in the Sept. 8 issue of Circulation. The study analyzed data from 2,521 patients in the SCD-HeFT trial, the 2005 study that found that ICD therapy reduces overall mortality by 23% in patients with advanced heart failure and low ventricular ejection fraction. Using the Seattle Heart Failure Model, a prediction model based on routinely collected clinical variables, Levy et al. categorized the patients into five risk quintiles based on their predicted all-cause mortality with standard therapy. The study found that patients in the highest risk quintile had a slightly higher risk of mortality with an ICD than without it
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