Implantable cardioverter-defibrillators in non-ischaemic cardiomyopathy: a need or not?

[...]aside from training lay public in basic life support and increasing access to public automatic defibrillators, our efforts in practice are aimed at SCD prevention in high-risk patients. [...]the guidelines of the European Society of Cardiology recommend implantation of an ICD in patients with ischaemic cardiomyopathy and a left ventricular ejection fraction (LVEF) of ≤ 35% despite at least 3 months of optimal medical heart failure therapy and a New York Heart Association (NYHA) class II or III, (class I, level of evidence A), and state that ICD implantation should be considered in patients with non-ischaemic cardiomyopathy, an LVEF of ≤ 35% despite optimal medical therapy and a NYHA class II or III (class IIA, level of evidence A) [5]. ICD therapy in the DANISH study caused a significant reduction of SCD, but not in all-cause mortality (hazard ratio [HR] 0.87; 95% confidence interval [95% CI] 0.68–1.12; P = 0.28) [6]. [...]there is discussion about the need for ICD therapy in patients with non-ischaemic cardiomyopathy in the modern era of advance heart failure medical therapy.