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Implementation of the NICE guidelines for the primary prevention of mortality from ventricular tachyarrhythmias: implications for UK electrophysiology centres; activity modelling from the UK-HEART study
  1. N P GALL,
  3. A ZAMAN*,
  4. S O'NUNAIN,
  5. K A A FOX,
  6. A FLAPAN,
  7. J NOLAN
  1. King's College Hospital, London
  2. *Freeman Hospital, Newcastle-upon-Tyne
  3. †Royal Infirmary, Edinburgh
  4. ‡North Staffordshire Hospital
  5. UK
  1. NP Gall, Department of Cardiology, King's College Hospital, Denmark Hill, London SE5 9RS, UK;nick.gall{at}

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It is now well established that the implantable cardioverter-defibrillator (ICD) is the most effective treatment for the primary prevention of life threatening ventricular arrhythmia.1 ,2 Despite this, its widespread use in the UK for this indication has been minimal, at least in part because of perceived resource implications. In September 2000, the National Institute for Clinical Excellence (NICE) recommended electrophysiological testing (EPS) for all patients with a history of myocardial infarction who have an ejection fraction of less than 35% and three or more beats of non-sustained ventricular tachycardia (NSVT) on a 24 hour Holter monitor. NICE further recommended that all patients in whom a significant ventricular arrhythmia is induced at EPS should have an ICD implanted. The potential effect of the NICE guidelines on workload in UK electrophysiology centres has not been evaluated.

UK-HEART examined the utility …

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