6/28/23, 1:15 AM DEFINITE Pathway Feedback Search Clinical Topics Home Studies DEFINITE DEFINITE Disease Disease Disease Dilated cardiomyopathy Heart failure Ventricula Trial question What is the role of prophylactic implantation of an ICD in patients with nonischemic dilated cardiomyopathy? Study design Multi-center Open label RCT Population Characteristics of study participants 29.0% female N = 458 71.0% male 458 patients (132 female, 326 male) Inclusion criteria: patients with nonischemic dilated cardiomyopathy, an LVEF < 36%, and premature ventricular complexes or nonsustained VT Key exclusion criteria: NYHA class IV congestive HF, had permanent pacemakers, in whom cardiac transplantation appeared to be imminent, familial cardiomyopathy associated with sudden death, and acute myocarditis or congenital heart disease Interventions N=229 implantation of a cardioverter-defibrillator (plus standard medical therapy) N=229 standard medical therapy alone (ACE inhibitors and -blockers, in addition to digoxin and diuretics if necessary) https://web.pathway.md/studies/recPMBpEiRRDrkRef 1/2 6/28/23, 1:15 AM DEFINITE Pathway Primary outcome Sudden death from arrhythmia 14.0 14 10.5 7.0 3.5 3 Significant decrease 0.0 Implantation of a cardioverter-defibrillator Standard medical therapy alone Significant decrease in sudden death from arrhythmia (3 vs. 14; HR 0.2, 95% CI 0.06 to 0.71) Secondary outcomes No significant difference in death (28 vs. 40; HR 0.65, 95% CI 0.4 to 1.06) Conclusion In patients with nonischemic dilated cardiomyopathy, an LVEF < 36%, and premature ventricular complexes or nonsustained VT, implantation of a cardioverter-defibrillator was superior to standard medical therapy alone with respect to sudden death from arrhythmia. Reference Kadish A, Dyer A, Daubert JP et al. Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. N Engl J Med. 2004 May 20;350(21):2151-8. Open reference URL https://web.pathway.md/studies/recPMBpEiRRDrkRef 2/2