Table 1

 Randomised trials of ICDs for primary and secondary prevention of SCD in patients with heart failure

Name of trialHeart failure aetiology and severityNumber of patientsAdditional risk stratification toolTreatment groupsPrimary and *secondary outcomesResult
CABG, coronary artery bypass graft; CRT, cardiac resynchronisation therapy; DCM, idiopathic dilated cardiomyopathy; EPS, electrophysiological study; ICD, implantable cardioverter-defibrillator; IHD, ischaemic heart disease; LVEF, left ventricular ejection fraction; MI, myocardial infarction; NS, non-significant; NSVT, non-sustained ventricular tachycardia; NYHA, New York Heart Association; PVC, premature ventricular complex; QOL, quality of life; SAECG, signal averaged ECG; VF, ventricular fibrillation; VT, ventricular tachycardia.
AVID29Mean LVEF 32%1016Resuscitated VF or VT1. Class III antiarrhythmic drugs1. Total mortality1.39% relative risk reduction
2. ICD*2. QOL
*3. Cost
CIDS30Mean LVEF 34%659Resuscitated VF or VT or unmonitored syncope1. Amiodarone1. Total mortality1.20% relative risk reduction (NS)
2. ICD*2. Arrhythmic death2.33% relative risk reduction (NS)
MADIT17Previous MI, NYHA I–III, LVEF <35%196Asymptomatic NSVT with inducible sustained VT at EPS1. Medical treatment1. Total mortality1.54% relative risk reduction
2. ICD
MUSTT18IHD, LVEF <40%704Asymptomatic NSVT with inducible sustained VT at EPS1. Antiarrhythmics and ICD1. Cardiac arrest or death from arrhythmia1.27% relative risk reduction
2. No antiarrhythmic treatment*2. Total mortality2.20% relative risk reduction
*3. Sustained VT3. NS
CABG-Patch14CABG surgery, LVEF <36%900Abnormal SAECG1. ICD1. Total mortality1. NS
2. Control
MADIT II4Prior MI, LVEF <30%1232None1. Medical treatment1. Total mortality1. 31% relative risk reduction
2. ICD
SCD-HeFT9IHD or DCM, NYHA II–III, LVEF <35%>2500None1. Amiodarone1. Total mortality1. Amiodarone v placebo: No reduction. ICD v placebo: 23% relative risk reduction
2. Placebo
3. ICD
AMIOVIRT31DCM, NYHA I–III, LVEF <35%103Asymptomatic NSVT1. Amiodarone1. Total mortality1. NS
2. ICD*2. Arrhythmia-free survival2. NS
*3. QOL3. NS
*4. Cost4. NS
CAT7DCM <9 months, NYHA II–III, LVEF <30%104None1. Control1. Total mortality1. NS
2. ICD
DEFINITE12DCM, LVEF <36%458PVCs or NSVT1. Medical treatment1. Total mortality1. 35% relative risk reduction (NS)
2. Medical treatment + ICD2. Arrhythmic death2. 80% relative risk reduction
COMPANION8IHD or DCM, NYHA III–IV, LVEF <35%1520None1. Control 2. CRT1. Death from or hospitalisation for any causeCRT ICD v control 1. 19% relative risk reduction
3. CRT with ICD*2. Death or hospitalisation from heart failure2. 40% relative risk reduction
*3. Total mortality3. 36% relative risk reduction