http://www.theheart.org/web_slides/1143909.do A study on sudden cardiac death in heart failure (SCD-HeFT) using randomized to conventional therapy for CHF plus placebo, conventional therapy plus amiodarone, or conventional therapy plus a conservatively programmed, shock- only, single-lead ICD

1. SCD-HeFT (Sudden Cardiac Death in
Heart Failure)

2. SCD-HeFT (Sudden Cardiac Death in Heart Failure)
G Bardy (Seattle Institute for Cardiac Research, WA)
American College of Cardiology 2004 Scientific Sessions
• Population and treatment:
2521 patients with NYHA class 2-3 HF of either ischemic or nonischemic
etiology and an LVEF <35%
Randomized to conventional therapy for CHF plus placebo, conventional
therapy plus amiodarone, or conventional therapy plus a conservatively
programmed, shock- only, single-lead ICD
Placebo and amiodarone were administered in a double-blind fashion
• Primary end point:
Death from any cause

3. SCD-HeFT: Results
• Adding an ICD to standard therapy reduced the hazard ratio for five-year all-
cause mortality by 23% vs placebo
Three- and five-year all-cause mortality by treatment group
All-cause mortality ICD (n=829) , % Amiodarone (n=845), % Placebo (n=847), %
Three years 17.1 24.0 22.3
Five years 28.9 34.1 35.8
Hazard ratios at five years vs placebo for all-cause mortality
Therapy Hazard ratio (97.5% CI) p
Amiodarone vs placebo 1.06 (0.86–1.30) 0.53
ICD vs placebo 0.77 (0.62–0.96) 0.007

4. SCD-HeFT: Commentary*
"Because MADIT II and SCD-HeFT were both similar in the risk reduction that they
reported, we would have to conclude that there is enough evidence to move
forward."
- Dr Kim A Eagle
"These results also emphasize the national need to continue to develop and
implement new methods to further identify patients who will benefit from life-saving
ICD therapy."
- Dr Michael E Cain
*All comments from The experts on SCD-HeFT: Implement now, but seek more discriminating ICD
patient-selection criteria (http://www.theheart.org/article/221157.do)

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