Improved Survival with an Implanted Defibrillator in Patients with Coronary Disease at High Risk for Ventricular Arrhythmia

Unsustained ventricular tachycardia in patients who have had a previous myocardial infarction and have left ventricular dysfunction has been associated with a two-year mortality rate in the range of 30 percent. 1 – 3 Antiarrhythmic therapy has been widely used for unsustained ventricular tachycardia, but there has been no evidence of improved survival with this treatment. 4 – 6 In December 1990, we initiated a prophylactic trial in which high-risk patients with coronary heart disease and asymptomatic unsustained ventricular tachycardia were randomly assigned to receive an implantable cardioverter–defibrillator or conventional medical therapy. To ensure a population at high risk for malignant ventricular arrhythmias, 7 , . . .