Journal
EUROPACE
Volume 20, Issue -, Pages F211-F216Publisher
OXFORD UNIV PRESS
DOI: 10.1093/europace/eux324
Keywords
Implantable cardioverter-defibrillator; Sudden cardiac death; Non-ischaemic cardiomyopathy; Total mortality
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Aim Primary prophylactic implantable cardioverter defibrillators (ICDs) have demonstrated a clear all-cause mortality benefit in patients with ischaemic cardiomyopathy, with less compelling evidence supporting its use in patients with non-ischaemic cardiomyopathy (NICM). We performed a meta-analysis of randomized controlled trials (RCTs) evaluating the role of ICD for reduction in total mortality in NICM patients. Methods and results An electronic search on PubMed, the Cochrane Library, and EMBASE databases was performed to identify the RCTs evaluating the role of prophylactic ICD placement in NICM patients. Mantel-Haenszel risk ratio (RR) fixed-effects model was used to summarize data across treatment arms. Random-effects model was used if heterogeneity (l(2)) >= 25. Patients with cardiac resynchronization therapy pacemaker (CRT-P) were included in the control group. Six RCTs, with a total of 3128 patients and a mean follow-up period of 48 +/- 22 months comparing ICD with medical therapy in NICM were included in this analysis. There was a significant reduction in all-cause mortality in the ICD group compared with the medical therapy group [RR 0.79, 95% confidence interval (95% CI) 0.68-0.92; P= 0.002]. No publication bias was noted. Conclusion Currently available evidence demonstrates that the use of ICD provides a clear and significant reduction in all- cause mortality among patients with NICM.
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