Implantable Cardioverter Defibrillators Efficacious in Real-World Practice

Implantable cardioverter defibrillators reduce mortality associated with left ventricular systolic dysfunction, a systematic review in Annals of Internal Medicine concludes.
The federally funded review, undertaken to measure the effectiveness of ICDs "under usual clinical practice conditions," examined observational studies as well as randomized controlled trials. Randomized-trial data comprising over 8500 participants showed the devices lowered all-cause mortality by 20%; observational studies, including some 9450 subjects, showed an even greater reduction, 46%. (According to the authors, the higher benefit in observational studies may be due to physicians choosing healthier patients to receive ICDs.)
The authors say their investigation also affirms the current recommendation to "delay ICD implantation after acute coronary events or coronary revascularization."