MASSDEVICE ON CALL — New data on implantable cardioverter defibrillators suggests that devices may help even less-sick patients prolong their lives.
The implants are generally indicated for patients who have fairly severe deficiencies in the heart’s left ventricle’s ability to pump blood coming from the left atrium out to the aorta. Normal left ventricular ejection fraction, or LVEF, is generally defined as between 50%-70%. Lower rates are considered a sign of potential dysfunction or heart failure.
Most clinical trials focus on patients with LVEF below 30%, but Duke University researchers found survival improvements in patients with LVEF between 30%-35% as well.
Mortality dropped from 55% to 51.4% at 3 years in patients with LVEF between 30%-35% who had an ICD, researchers reported. For patients with LVEF below 30%, ICDs were associated with a drop in mortality from 57.6% to 45%.
"Our findings fill an important gap in knowledge, as most randomized clinical trials of ICDs include heart failure patients with a median LVEF of well below 30%," lead investigator Dr. Sana Al-Khatib said in prepared remarks."Given that a large number ICDs are implanted in patients with a LVEF between 30 to 35 percent, understanding outcomes in such patients is important."
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