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Implantable Defibrillators Boost Survival, Heart Failure

Chronic heart disease patients need more attention on prevention strategies

TUESDAY, June 13 (HealthDay News) -- Patients with chronic ischemic heart disease have improved chances of survival when treated with either single-chamber or dual-chamber implantable cardioverter-defibrillators (ICDs), but as they live longer, they have an almost fourfold risk of developing heart failure, according to a study in the June 20 issue of Circulation: Journal of the American Heart Association.

Ilan Goldenberg, M.D, of the University of Rochester Medical Center in New York, and colleagues analyzed data on patients enrolled in the Multicenter Automatic Defibrillator Implantation Trial (MADIT) II to ascertain clinical factors and outcomes associated with heart failure events. The MADIT II randomized 1,232 patients who had a myocardial infarction one month or more before entry to the study to receive either an ICD or conventional medical therapy.

Among the conventional therapy patients, the odds of first and recurrent heart failure were 1.39 and 1.58, respectively. For the ICD patients, the odds were 1.90 and 1.74, respectively. For patients who received a single chamber ICD, the overall survival benefit was 42 percent and for patients with a double chamber ICD, the survival benefit was 51 percent.

"Some patients whose lives were prolonged by ICDs were sicker and more prone to develop heart failure," Goldenberg said in a statement. "The ICD kept them alive by preventing sudden cardiac death as their heart disease naturally progressed to heart failure."

The study was supported by a grant from the Guidant Corp.

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