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An implantable cardioverter defibrillator but not amiodarone reduced risk of death in congestive heart failure

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 Q In patients with congestive heart failure (CHF), does amiodarone or an implantable cardioverter defibrillator (ICD) reduce all cause mortality more than placebo?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★★☆ Cardiology ★★★★★★☆


Embedded ImageDesign:

randomised placebo controlled trial (Sudden Cardiac Death in Heart Failure Trial [SCD-HeFT]).

Embedded ImageAllocation:


Embedded ImageBlinding:

blinded (clinicians and patients).*

Embedded ImageFollow-up period:

median 46 months.

Embedded ImageSetting:

145 centres in Canada and the US.

Embedded ImagePatients:

2521 patients who were ⩾18 years of age (median age 60 y, 77% men) with New York Heart Association (NYHA) class II or III chronic, stable CHF from ischaemic causes (left ventricular systolic dysfunction [LVSD] with marked coronary artery stenosis or documented myocardial infarction) or non-ischaemic causes (LVSD without marked stenosis); and an LV ejection fraction <35%.

Embedded ImageIntervention:

amiodarone (loading dose of 800 mg daily for 1 wk, 400 mg daily for 3 wks, then a …

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  • * See glossary.

  • For correspondence: Dr G H Bardy, Seattle Institute for Cardiac Research, Seattle, WA, USA.

  • Sources of funding: National Institutes of Health; Medtronic; Wyeth-Ayerst Laboratories; Knoll Pharmaceuticals.