[Idiopathic dilated cardiomyopathy--an appraisal in 2005].

Patients who present with an impaired left ventricular (LV) function of nonischemic origin (EF < or = 35%), should first undergo intensified heart failure therapy with angiotensin-converting enzyme (ACE) inhibitors, beta-blockers and diuretics. If the impairment of LV function persists for 3-9 months despite adequate therapy, the implantation of a defibrillator (ICD) seems to be reasonable for the primary prevention of sudden cardiac death in these patients. If patients present with non-sustained ventricular tachycardias, ICD implantation and treatment with amiodarone are probably equally effective and better than mere heart failure therapy. In patients presenting with an indication for biventricular pacing, a biventricular ICD should be used.