How To Better Identify Patients That Do Not Benefit From Prophylactic ICD Therpy.

The implantable cardioverter defibrillator (ICD) has been demonstrated to improve survival by reducing sudden cardiac death (SCD) in patients with a low left ventricular ejection fraction (LVEF). Randomised trial data suggest that this mortality reduction is not constant among those implanted with a device, and has raised the significance of non-sudden cardiac death (non-SCD) as an important mode of death predicting limited benefit from ICD therapy. In this review article we explore the role of non-SCD and the risk prediction models that may aid identification of low LVEF patients unlikely to gain significant benefit from ICD therapy.