Congestive Heart Failure, Ischemic and Non-ischemic Cardiomyopathy, Left Ventricular Systolic Dysfunction, Sudden Cardiac Death Primary Prevention
Conditions
Keywords
Sudden Cardiac Death, Implantable Cardioverter Defibrillator, Ventricular Fibrillation
Brief summary
No clinical trial that has examined the role of implantable cardioverter defibrillator (ICD) therapy in the prevention of Sudden Cardiac Death (SCD) has provided outcome data for longer than a few years. The NHLBI sponsored and placebo-controlled Sudden Cardiac Death in heart Failure Trial (SCD-HeFT) conducted from 1997 to 2003 had the largest number of patients and the longest average follow-up at 45.5 months. This study changed the national reimbursement policy for ICD therapy and remains the reference point for all other ICD evaluations in patients with congestive heart failure from ischemic or non-ischemic systolic dysfunction. Despite the outcome, the role of ICD therapy in the management of patients with heart failure has been questioned because of four principal concerns: numbers needed to treat to save a life, lead integrity over time, the negative consequences of shock therapy, and the cost of therapy. The purpose of this trial is to track down the remaining patients for a one-time follow-up regarding key outcome data.
Detailed description
Long-term outcome data for implantable cardioverter defibrillator (ICD) therapy is sorely needed. We will acquire these data by re-approaching the patient population from the original Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT).\[Bardy 2005\] This research is supported by the National Heart Lung and Blood Institute of the National Institutes of Health. SCD-HeFT was originally conducted from 1997 to 2003. It demonstrated unequivocally that ICD's save lives in patients with heart failure compared to placebo or amiodarone. More than 26 peer-reviewed publications, including three NEJM papers, have resulted from this work.\[Bardy 2005, Poole 2008, Mark 2008\] Despite the quality of SCD-HeFT and the evidence of the life-saving ability of ICD therapy, the role of ICD therapy in the management of patients with heart failure continues to be questioned. This study will provide long-term follow-up of the SCD-HeFT patients, which will now exceed 10 years on average.
Interventions
None listed
Sponsors
National Institutes of Health (NIH)
Abbott Medical Devices
Seattle Institute for Cardiac Research
Study design
Observational model
CASE_CONTROL
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
This is a one time follow-up on patients previously enrolled. -
Exclusion criteria
This is a one time follow-up on patients previously enrolled. \-
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To compare 10-year mortality data on the remaining 1855 SCD-HeFT patients since the close of follow-up from October 31, 2003 in the 3 arms of the trial (ICD, placebo and amiodarone)based upon an intent-to-treat and an on-treatment analysis. | Two years |
Secondary
| Measure | Time frame |
|---|---|
| To obtain outcome data in the major subgroups of SCD-HeFT: ischemic v. non-ischemic and NYHA Class II vs. Class III heart failure, and in woman and minorities. | Two years |
| To obtain 10-year ICD use rates (appropriate and inappropriate therapy), complication rates, lead failure rates and replacement rates. | Two Years |
| To validate or refute the observation that amiodarone increases mortality in NYHA Class III patients. | Two years |
| To obtain 10-year hospitalization and major procedure data. | Two years |
| To obtain 10-year quality of life data. | Two years |
Countries
United States
Outcome results
None listed