Article redicting cardiac events using ventricular dyssynchrony in patients who received implantable cardioverter defibrillators: Are more treatment options required?

Yoshinaga, Keiichiro

The survival rate associated with heart failure (HF) has been significantly improved in recent years due to improved preventive approaches and device treatments to improve cardiac function and prevent sudden cardiac death.1 Implantable devices used in cardiac resynchronization therapy (CRT) and implantable cardioverter defibrillators (ICDs) contribute to improving outcomes for HF patients. The use of ICD implantation has been stable over the years and overall the ICD has resulted in reduced mortality.2 However, it is true that limited numbers of patients have benefited from ICD implantation.3 A meta-analysis showed that some sub-study populations had no benefits from ICD implantation.4 At present, ICD implantation may be the best therapeutic option for preventing sudden cardiac death in patients with left ventricular ejection fraction (LVEF) of <35%. If predictors for ICD effectiveness or non-response can be identified, other treatment approaches may be available to the non-responder. In addition, with implantable devices, infective endocarditis can be a cause for major concern, and therefore unnecessary or ineffective implantation should be avoided.5, 6

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