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		<updated>2018-04-19T13:26:44Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: /* Research */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;&#039;&#039;&#039;Avirup Guha, M.B.B.S.&#039;&#039;&#039;, Associate Editor-in-Chief of [[Ventricular Tachycardia]], WikiDoc Foundation&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Contact:&#039;&#039;&#039; mailto:avirup.guha@gmail.com; &lt;br /&gt;
&lt;br /&gt;
__NOTOC__&lt;br /&gt;
----&lt;br /&gt;
Hi everyone coming to my page. I am Avirup Guha, a cardiology fellow at Ohio state University. My subjects of interest – Cardiology, Cardio-oncology and cardiac MRI&lt;br /&gt;
&lt;br /&gt;
==Education==&lt;br /&gt;
&lt;br /&gt;
2015 July – Present : Cardiology Fellowship, The Ohio State University&lt;br /&gt;
&lt;br /&gt;
Proficiency achievement goal by end of training:&lt;br /&gt;
&lt;br /&gt;
1. Cardiac CT – level 2&lt;br /&gt;
&lt;br /&gt;
2. Vascular imaging – level 2&lt;br /&gt;
&lt;br /&gt;
3. Echo – level 3 – board certified&lt;br /&gt;
&lt;br /&gt;
4. Nuclear – level 2 – board certified&lt;br /&gt;
&lt;br /&gt;
2012 July – 2015 June: Internal Medicine Residency, Board Certified, Georgia Regents University&lt;br /&gt;
&lt;br /&gt;
2005 August – 2011 May: Medical School, M.B.B.S., Seth G.S. Medical College, Mumbai, India&lt;br /&gt;
&lt;br /&gt;
==Research==&lt;br /&gt;
&lt;br /&gt;
2015 July - present: Ohio State University, Columbus, OH (various) - review publications for description of project.&lt;br /&gt;
&lt;br /&gt;
2012 July – 2015 July: Georgia Regents University, Augusta, GA (Stan Norris Nahman Jr, MD, Robert Sorrentino, MD) &#039;&#039;&#039;&amp;quot;mining the USRDS database&amp;quot;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2012 July – 2015 June: Georgia Regents University, Augusta, GA (Paul O’Connor, PhD) &#039;&#039;&#039;&amp;quot;Hydrogen voltage-gated channel 1 (HVCN-1) to the pathophysiology of hypertension and chronic kidney disease&amp;quot;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2006 September—2007 March: Seth G.S. Medical college, Mumbai,( Dr. Nirmala Rege, Professor: Pharmacology) &#039;&#039;&#039;“Immunostimulatory Potential of Indian Medicinal Plants on Thymocytes of Swiss Albino Mice”&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
==Research Allowance==&lt;br /&gt;
&lt;br /&gt;
2017: CCTS Research Informatics Services Voucher for obtaining the National Readmission dataset - $1750&lt;br /&gt;
&lt;br /&gt;
2015: CCTS Research Informatics Services Voucher for obtaining the National Inpatient Sample dataset - $3590&lt;br /&gt;
&lt;br /&gt;
2009: Indian Council of Medical Research, Short Term Studentship (Pharmacology)&lt;br /&gt;
&lt;br /&gt;
==Publications==&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Full Publications&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2018: Foraker R, Guha A, Chang H, O’Brien E, Bower J, Crouser E, Rosamond W, Raman SV. Survival after MI in a Community Cohort Study: Contribution of Comorbidities in NSTEMI. Glob Heart. 2018 Feb 3. pii: S2211-8160(18)30002-4. (PMID: 29409724)&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Snider MJ, Boyd M, Afzal M, Badin A, Godara H, Liu Z, Tyler J, Weiss R, Kalbfleisch S, Augostini R, Hummel J, Houmsse M, Daoud EG. Initiation and Outcomes with Class Ic Antiarrhythmic Drug Therapy. Indian Pacing Electrophysiol J. 2017 Dec 7. pii: S0972-6292(17)30192-4. doi: 10.1016/j.ipej.2017.12.001. [Epub ahead of print] (PMID: 29225010)&lt;br /&gt;
&lt;br /&gt;
2017: Liu E, Guha A, Jia K, Ayers AM, Boudoulas KD, Bertino E, Franco V. Cardiogenic shock in a patient being treated with Atezolizumab for metastatic non-small cell lung cancer. Lung Cancer. 2017 Jul 29. pii: S0169-5002(17)30416-6. doi: 10.1016/j.lungcan.2017.07.028. [Epub ahead of print] (PMID: 28780994, 29292070)&lt;br /&gt;
&lt;br /&gt;
2017: Wiczer TE, Levine LB, Brumbaugh J, Coggins J, Zhao Q, Ruppert AS, Rogers K, McCoy A, Mousa L, Guha A, Maddocks K, Christian B, Andritsos LA, Jaglowski S, Devine S, Baiocchi R, Woyach J, Jones J, Grever M, Blum KA, Byrd JC, Awan FT: Incidence, Risk Factors, and Management of Atrial Fibrillation in Patients Receiving Ibrutinib for Hematologic Malignancies. Blood Adv. 2017 1:1739-1748; doi: 10.1182/bloodadvances.2017009720 (PMID: 29296820)&lt;br /&gt;
&lt;br /&gt;
2017: Dunleavy M, Guha A, Ernst K, Sullivan M, Voelkel AJ, Raman SV, Baker C, Dean S. Running without a vein: Congenital Absence of the Right Common Iliac Vein. Int J Cardiovasc Imaging. 2017. Accepted for publication.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Gao X, Dunleavy M, Liu E, Patel D, Fedorov VV, Daoud EG. Eleven-year trends of inpatient pacemaker implantation in patients diagnosed with sick sinus syndrome. J Cardiovasc Electrophysiol. 2017 May 4. doi: 10.1111/jce.13248. [Epub ahead of print] (PMID: 28471545)&lt;br /&gt;
&lt;br /&gt;
2016: Li N, Csepe TA, Hansen BJ, Sul LV, Kalyanasundaram A, Zakharkin SO, Zhao J, Guha A, Van Wagoner DR, Kilic A, Mohler PJ, Janssen PM, Biesiadecki BJ, Hummel JD, Weiss R, Fedorov VV: Adenosine-Induced Atrial Fibrillation: Localized Reentrant Drivers in Lateral Right Atria due to Heterogeneous Expression of Adenosine A1 Receptors and GIRK4 Subunits in the Human Heart. Circulation. 2016 Aug 9;134 (6):486-98. (PMID: 27462069)&lt;br /&gt;
&lt;br /&gt;
2016: O&#039;Connor PM, Guha A, Stilphen CA, Sun J, Jin C: Proton channels and renal hypertensive injury: a key piece of the Dahl salt-sensitive rat puzzle? Am J Physiol Regul Integr Comp Physiol. 2016 Feb 3:ajpregu.00115.2015. (PMID: 26843580)&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Merchen LA: Cerebral Cryptococcoma – but Why? J Kuwait Med Assoc. 2015 November. 47(4):346-347.&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Maddox WR, Colombo R, Nahman NS Jr, Kintziger KW, Waller JL, Diamond M, Murphy M, Kheda M, Litwin SE, Sorrentino RA. Evaluation Of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Heart Rhythm. 2015 Aug 4. pii: S1547-5271(15)01017-6. (PMID: 26253036)&lt;br /&gt;
&lt;br /&gt;
2015: Ayoola R, Guha A, Daram SR: Gastrointestinal Bleeding as the Initial Presentation of HIV/AIDS. Gastrointest Endosc. 2015 Apr 25. pii: S0016-5107(15)02117-3. (PMID: 25922245)&lt;br /&gt;
&lt;br /&gt;
2014: Jin C, Sun J, Stilphen CA, Smith SME, Ocasio H, Bermingham B, Darji S, Guha A, Patel R, Geurts AM, Jacob HJ, Lambert NA, O’Connor PM: HV1 ACTS AS A sodium SENSOR AND promotes superoxide production in medullary thick ascending limb of Dahl SALT-SENSITIVE rats. Hypertension. 2014 Sep; 64(3):541-50. (PMID: 24935944)&lt;br /&gt;
&lt;br /&gt;
2014: Murphy M, Krothapalli S, Cuellar J, Kanjanauthai S, Heeke B, Sharma P, Guha A, Barnes VA, Litwin S, Sharma G: Prognostic Value of Normal Stress Echocardiography in Obese Patients. J Obes. 2014 Aug; 2014:419724. (PMID: 25258682)&lt;br /&gt;
&lt;br /&gt;
2014: Guha A, Kulkarni HS: ATS Patient Series: What is Histoplasmosis? Am J of Resir Crit Care Med. 2012 Apr; 185:1–2.&lt;br /&gt;
&lt;br /&gt;
2012: Madhwal S, Goldberg J, Barcena J, Guha A, Gogate P, Cmolik B, Elgudin Y: An Unusual Cause of Acute Mitral Regurgitation: Idiopathic Hypereosinophilic Syndrome. Ann Tho Surg. 2012 Mar; 93(3):974-7. (PMID: 22364989).&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Published Abstracts&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Dunleavy M, Raman SV, Harfi TT. Left Atrial Appendage Enhancement Pattern on CT Pulmonary Venograms is Associated with Left Atrial Appendage Emptying Velocity as Measured by Doppler signal During Transesophageal Echocardiography. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Dunleavy M, Raman SV, Harfi TT. Cardiology Fellows Learning Curve and Inter-observer Variability in the Interpretation of the Left Atrial Appendage on Cardiac CT Pulmonary Venograms. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Dunleavy M, Raman SV, Harfi TT. Accuracy of Non-ECG Gated, Single Phase, Contrast-Enhanced Cardiac CT Pulmonary Venography in Left Atrial Appendage Thrombus Rule Out as compared to Transesophageal Echocardiogram. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Dunleavy M, Guha A, Raman SV, Harfi TT. Coronary Artery Calcification as Detected on Pre-Atrial Fibrillation Computed Tomography(CT) Pulmonary Venogram Helps Optimize Patient Selection for Statin Therapy in Patients with Atrial Fibrillation. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Liu E, Guha A, Dunleavy M, Obarski T. Is Upper Endoscopy Required in Cirrhotic Patients prior to TEE? Accepted for poster at American Society of Echocardiography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Buck B, Guha A, Arora S, Awan FT, Lopez-Mattei JC, Plana-Gomez JC, Oliviera G, Fradley M, Addison D. Survival of in-hospital cardiac arrest among cancer patients. Submitted to European Society of Cardiology 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Addison D, Derbala M, Wiczer TE, Byrd JC, Awan FT. Ventricular Arrhythmias in Patients Managed With Ibrutinib For Cancer Immunotherapy. Accepted for poster ACC 2018. J Am Coll Cardiol. March 2018; 71(11_S): doi: 10.1016/S0735-1097(18)30820-9&lt;br /&gt;
&lt;br /&gt;
2018: Briston D, Guha A, Zubizarreta N, Daniels C, Bradley E. Results From the WISH-ACHD Study: Women&#039;s Initiative in the Study of Hospitalizations in Adult Congenital Heart Disease. Accepted for oral presentation ACC 2018. March 2018; 71(11_S):10.1016/S0735-1097(18)31070-2&lt;br /&gt;
&lt;br /&gt;
2017: Okabe T, Buck B, Guha A, Gao X, Liu E, Dunleavy M, Haddad D, Daoud EG. Short- And Mid-term Hospitalization for Recurrence Of Atrial Fibrillation After Catheter Ablation In Obese Patients. Accepted for oral presentation at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A16417.&lt;br /&gt;
&lt;br /&gt;
2017: Buck B, Guha A, Gao X, Liu E, Dunleavy M, Haddad D, Daoud EG, Okabe T. CHA2DS2-Vasc Score Predicts 30-day Thromboembolic Risk after Cardioversion of Atrial Fibrillation. Accepted for poster at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A18484.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Dunleavy M, Asad SY, Gao X, Liu E, Haddad D, Baliga R, Awan F, Mehta L. 12 Year Trends In Out Of Hospital Cardiac Arrest In Patients With Cancer. Accepted for poster at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A15968.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Yuan Z, Gao X, Liu E, Dunleavy M, Derbala M, Efebera Y, Baliga R, Smith S. National Trends in Hospitalization of Patients with Diastolic Heart Failure and Concurrent Amyloidosis. Accepted for poster at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A11678.&lt;br /&gt;
&lt;br /&gt;
2017: Buck B, Guha A, Gao X, Haddad D, Liu E, Dunleavy M, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Acute Coronary Syndrome and Concurrent Amyloidosis. Accepted for poster at the European Heart Congress meeting 2017. Eur Heart J. 2017; 38 (S1): ehx504.P4690.&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Houmsse M, Snider M, Daoud EG. Exercise Testing in Patients Treated with Class IC Antiarrhythmic Drug. Accepted for poster at HRS 2017 meeting. Heart Rhythm. 2017; 14 (5S): S514–S563&lt;br /&gt;
&lt;br /&gt;
2017: Buck B, Guha A, Gao X, Awan F, Hofmeister C, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Atrial Fibrillation and Concurrent Amyloidosis. Accepted for poster at HRS 2017 meeting. Heart Rhythm. 2017; 14 (5S): S144–S234&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Xiang X, Patel D, Fedorov VV, Daoud EG: 11 year Trends and Utilization Patterns of Cardiac Implantable Electronic Devices in Patients Diagnosed With Sick Sinus Syndrome. Accepted for poster AHA 2016. Circulation. 2016;134: A12756.&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Bower JK, Foraker R, Smith S: Ventricular Tachycardia and Sick Sinus Syndrome in Neoplasia. Accepted for poster Heart Rhythm 2016. Heart Rhythm. 2016; 13 (5S): S340–S426&lt;br /&gt;
&lt;br /&gt;
2015: Murphy M, Guha A, Maddox WR, Waller J, Sorrentino RA, Diamond M, Nahman, NS Jr: Modified HASBLED bleeding risk score in dialysis patients with atrial fibrillation. Accepted for poster AHA 2015. Circulation. 2015; 132: A12014&lt;br /&gt;
&lt;br /&gt;
2014: Patel NJ, Deshmukh AJ, Guha A, Mitrani RD, Paydak H, Viles-Gonzales J, Kowalski M et al: Gender, Racial and Insurance disparities in the Cardiac Resynchronization Therapy: Trends over the last decade. Circulation. Accepted for poster AHA 2014. Circulation. 2014; 130:A206.&lt;br /&gt;
&lt;br /&gt;
2014: Deshmukh A, Deshmukh AJ, Guha A, Desimone CV, Joshi M et al: Utilization and Outcome of Therapeutic Hypothermia for Out of Hospital Cardiac Arrest. Accepted for poster AHA 2014. Circulation. 2014; 130:A19401.&lt;br /&gt;
&lt;br /&gt;
2014: Deshmukh A, Patel NJ, Deshmukh AJ, Guha A, Desimone CV, Joshi M et al: Seasonal Variation of Out of Hospital Cardiac Arrest. Accepted for poster AHA 2014. Circulation. 2014; 130:A51.&lt;br /&gt;
&lt;br /&gt;
2014: Maddox WR, Waller J, Guha A, J Cuellar J, Diamond M, Murphy M, Litwin S, Nahman NS Jr, Kheda M, Sorrentino R: A Dialysis-Specific Risk Stratification Score Improves Stroke Prediction in Dialysis Patients with Atrial Fibrillation. Accepted for poster AHA 2014. Circulation. 2014; 130:A17629.&lt;br /&gt;
&lt;br /&gt;
2014: Diamond M, Maddox WR, Waller J, Guha A, J Cuellar J, Murphy M, Litwin S, Kheda M, Sorrentino R, Nahman NS Jr: Risk Factors of Stroke or Mortality in and after 90 days of Atrial Fibrillation Diagnosis in Dialysis Patients. Accepted for poster ASN 2014. J Am Soc Nephrol. 2014; 25: FR-PO1029.&lt;br /&gt;
&lt;br /&gt;
2014: J Cuellar J, Waller J, Guha A, Diamond M, Sorrentino R, Murphy M, Litwin S, Nahman NS Jr, Kheda M, Maddox M: CHA2DS2VASc score predicts stroke in dialysis patients with atrial fibrillation. Accepted for oral presentation ACC 2014. J Am Coll Cardiol. 2014; 63(12_S): doi: 10.1016/S0735-1097(14)60297-7.&lt;br /&gt;
&lt;br /&gt;
2014: Murphy M, J Cuellar J, Waller J, Guha A, Diamond M, Sorrentino R, Litwin S, Nahman NS Jr, Kheda M, Maddox M: CHA2DS2VASc score predicts mortality in dialysis patients with atrial fibrillation. Accepted for poster ACC 2014. J Am Coll Cardiol. 2014; 63(12_S): doi: 10.1016/S0735-1097(14)60358-2.&lt;br /&gt;
&lt;br /&gt;
2014: Guha A, Sun J, O’Connor PM: Apical NH4Cl acts to reduce intracellular Na concentration in mTAL via cellular depolarization. Accepted for poster Experimental Biology 2014. FASEB J. April 2014 28:1098.6.&lt;br /&gt;
&lt;br /&gt;
2014: Maddox WR, Kintziger K, Colombo R, Guha A, Kheda M, Nahman NS Jr, Sorrentino R: Mortality Following Cardiac Implantable Electronic Device Infection in Dialysis Patients from the USRDS. Accepted for oral presentation Heart Rhythm 2014. Heart Rhythm. 2014; 11 (S5): AB28-03.&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Sorrentino RA, Ghaffari A, Colombo R, Ellington CL, Chebrolu P, Kheda M, Nahman Jr NS, Kintziger K : Non-traditional risk factors for myocardial infarction and systolic heart failure following kidney transplantation. Accepted for poster ESC 2013. Eur Heart J. 2013; 34 (S1): 312.&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Sorrentino RA, Colombo R, Kheda M, Nahman Jr NS, Kintziger K. Evaluation Of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Late breaking clinical trials/oral plenary presentation of Heart Rhythm. Heart Rhythm, May 2013; published online.&lt;br /&gt;
&lt;br /&gt;
2013: Maddox W, Kintziger K, Colombo R, Guha A, Kheda M, Nahman S, Sorrentino R: Risk of cardiac implantable electronic device infection in hemodialysis or peritoneal dialysis: evaluation of a large end stage renal disease database. Accepted for poster AHA 2013. Circulation. 2013; 128: A16808.&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman NS Jr, Kintziger K, Merchen T, Kheda M, Sorrentino R: Non-traditional risk factors for atrial fibrillation following kidney transplantation. Accepted for poster AHA 2013. Circulation. 2013; 128:A12632.&lt;br /&gt;
&lt;br /&gt;
2013: Ghaffari A, Ellington CL, Colombo R, Baer S, Huber L, Guha A, Whitlow M, Chebrolu P, Nahman Jr NS, Kintziger K, Merchen T: Vasculopathic risk factors for delayed graft function in kidney transplantation. Accepted for poster at American Transplant Congress 2013. Amer J Transplant. 2013; 13 (S5):525.&lt;br /&gt;
&lt;br /&gt;
2012: Madhwal S, Guha A, Atreja A, Gupta P, Albeldawdi M, Post A, Costa A: Is Metabolic syndrome post Liver Transplantation a Risk Factor for Cardiovascular Disease? Accepted for poster AHA 2013. Circulation. 2012; 126: A18429.&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Poster/Online Presentations (published and unpublished)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Cardona A, Nagaraja HN, Raman SV, Zareba KM. Prognostic value of midwall fibrosis in patients with preserved ejection fraction and structurally normal heart (pilot study). Accepted for poster at CMR 2018, Barcelona, Spain. Published online - &amp;lt;nowiki&amp;gt;http://cmr2018.org/wp-content/uploads/2018/01/Abstract-Supplement-Book.pdf&amp;lt;/nowiki&amp;gt;&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Okabe T, Buck B, Gao X, Liu E, Dunleavy M, Haddad D, Daoud EG. Short- And Mid-term Hospitalization for Recurrence Of Atrial Fibrillation After Catheter Ablation In Obese Patients. (2017 November) American Association of Cardiologist of Indian Origin Annual Meeting, Anaheim, California, USA. Unpublished.&lt;br /&gt;
&lt;br /&gt;
2017: Franco DA, Gao X, Guha A, Buck B, Patel D, Snider MJ, Boyd M, Afzal M, Badin A, Godara H, Liu Z, Tyler J, Weiss R, Kalbfleisch S, Augostini R, Hummel J, Houmsse M, Daoud EG. Initiation and Outcomes with Class Ic Antiarrhythmic Drug Therapy. (2017 October) Ohio ACC meeting, Columbus, Ohio, USA. Unpublished.&lt;br /&gt;
&lt;br /&gt;
2017: Briston D, Guha A, Zubizarreta N, Daniels C, Bradley EA. Pregnancy in Congenital Heart Disease: Analysis of Maternal Cardiovascular Hospitalizations. (2017 September) Annual International Symposium on Adult Congenital Heart Disease, Cincinnati, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Dunleavy M, Guha A, Ernst K, Sullivan M, Voelkel AJ, Raman SV, Baker C, Dean S. Running without a vein: Congenital Absence of the Right Common Iliac Vein. (2017 June) NASCI Case in Point. Accepted for online publication.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Gao X, Dunleavy M, Liu E, Patel D, Fedorov VV, Daoud EG. Eleven year trends of inpatient pacemaker implantation in patients diagnosed with sick sinus syndrome. (2017 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Houmsse M, Snider M, Daoud EG. Exercise Testing in Patients Treated with Class IC Antiarrhythmic Drug. (2017 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Gao X, Awan F, Hofmeister C, Daoud EG, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Atrial Fibrillation and Concurrent Amyloidosis. (2017 April): OSUCCC – James Annual Scientific Meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Chang H, O’Brien E, Bower J, Crouser E, Rosamond W, Raman SV, Foraker R. Community-based mortality risk due to acute coronary syndromes: An ARIC study. (2016 October): Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Bower JK, Foraker R, Smith S. Ventricular Tachycardia and Sick Sinus Syndrome in Neoplasia. (2016 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Dooling PC, Ramsey ML, Guha A, Sofowora G. Connective Tissue Disease Presenting as Pericardial Effusion with Tamponade. (2016 May) OSU Internal Medicine Research day, Case Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Ruden E, Raman S. Unusual cardiac iron overload in a sickle cell disease patient. (2015 October): Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2014: Baker S, Guha A, Mitulescu L, Murphy M, Cuomo J, Haydour Q, Sorrentino RA. (October 2014). Slow Excitation: The remarkable presentation of Wolff-Parkinson-White Anomaly with bradycardia: Georgia ACP meeting; Lake Lanier, Georgia, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman Jr NS, Kintziger K, Kheda M, Sorrentino RA. (November 2013). Evaluation of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Oral Presentation presented at: Georgia ACC fellows presentation; Lake Oconee, Georgia USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
==Oral Presentations==&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Gao X, Haddad D, Liu E, Dunleavy M, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Acute Coronary Syndrome and Concurrent Amyloidosis. (2017 October) Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A. Sinoatrial node: Bench to bedside: OSU Cardiology Grand Rounds, Columbus, Ohio, USA. (2016 February) Unpublished&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman Jr NS, Kintziger K, Kheda M, Sorrentino RA. Evaluation of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. (May 2013). &#039;&#039;&#039;Oral Presentation presented at: Heart Rhythm Society. Late Breaking Clinical Tria&#039;&#039;&#039;l; Denver, Colorado USA. Published&lt;br /&gt;
&lt;br /&gt;
2008: Guha A, Vaidya V, Shah M, Sanghai S, Shukla E, Parikh R, Gala P, Shingada A, Goray A, Mansukhani S, Shah V. (2008, March). &#039;&#039;&#039;Phantom limb and the role of Virtual Mirror Box.&#039;&#039;&#039; Oral Presentation presented at: &#039;&#039;Bombay Medical Congress; Mumbai&#039;&#039;, India.&lt;br /&gt;
&lt;br /&gt;
2007: Guha A, Agarwal A, Sawant A, Surekha S, Krishnamoorty S et al. (2007, March). &#039;&#039;&#039;Paediatric HIV.&#039;&#039;&#039; Oral Presentation presented at: &#039;&#039;Bombay Medical Congress&#039;&#039;; Mumbai, India.&lt;br /&gt;
&lt;br /&gt;
==Editorial Boards==&lt;br /&gt;
&lt;br /&gt;
Associate Editor in Chief for [[Ventricular Tachycardia]] Section of wikidoc&lt;br /&gt;
&lt;br /&gt;
Circulation Imaging: Ad-hoc reviewer.&lt;br /&gt;
&lt;br /&gt;
BMJ Case Reports: Ad-hoc reviewer.&lt;br /&gt;
&lt;br /&gt;
Journal of Hypertension and Heart Care: Member of the editorial board.&lt;br /&gt;
&lt;br /&gt;
Cureus: Ad-hoc reviewer.&lt;br /&gt;
&lt;br /&gt;
==Internet Educational Sites==&lt;br /&gt;
&lt;br /&gt;
Sharing information about boards and good literature is my passion http://www.avirupguha.co.nr&lt;br /&gt;
&lt;br /&gt;
[[Category:Medical Graduate]]&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=User:Avirupguha&amp;diff=1464119</id>
		<title>User:Avirupguha</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=User:Avirupguha&amp;diff=1464119"/>
		<updated>2018-04-19T13:18:19Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
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&lt;div&gt;&#039;&#039;&#039;Avirup Guha, M.B.B.S.&#039;&#039;&#039;, Associate Editor-in-Chief of [[Ventricular Tachycardia]], WikiDoc Foundation&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Contact:&#039;&#039;&#039; mailto:avirup.guha@gmail.com; &lt;br /&gt;
&lt;br /&gt;
__NOTOC__&lt;br /&gt;
----&lt;br /&gt;
Hi everyone coming to my page. I am Avirup Guha, a cardiology fellow at Ohio state University. My subjects of interest – Cardiology, Cardio-oncology and cardiac MRI&lt;br /&gt;
&lt;br /&gt;
==Education==&lt;br /&gt;
&lt;br /&gt;
2015 July – Present : Cardiology Fellowship, The Ohio State University&lt;br /&gt;
&lt;br /&gt;
Proficiency achievement goal by end of training:&lt;br /&gt;
&lt;br /&gt;
1. Cardiac CT – level 2&lt;br /&gt;
&lt;br /&gt;
2. Vascular imaging – level 2&lt;br /&gt;
&lt;br /&gt;
3. Echo – level 3 – board certified&lt;br /&gt;
&lt;br /&gt;
4. Nuclear – level 2 – board certified&lt;br /&gt;
&lt;br /&gt;
2012 July – 2015 June: Internal Medicine Residency, Board Certified, Georgia Regents University&lt;br /&gt;
&lt;br /&gt;
2005 August – 2011 May: Medical School, M.B.B.S., Seth G.S. Medical College, Mumbai, India&lt;br /&gt;
&lt;br /&gt;
==Research==&lt;br /&gt;
&lt;br /&gt;
2009: June—November Seth G.S. Medical college, Mumbai,( Dr. Shobna Bhatia, Head of the Department: Department of Gastroenterology) &#039;&#039;&#039;&amp;quot;Quality of nutrition, especially medium chain fatty acids, in patients of alcoholic liver disease as compared to alcoholics without liver disease&amp;quot;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2008: January—2009: October Seth G.S. Medical college, Mumbai,( Dr. Prafulla Kerkar, Head of the Department: Department of Cardiology) &#039;&#039;&#039;“To study the clinical profile and predictors of recurrence in patients with Stable Ventricular Tachycardia”&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2006: September—2007: March Seth G.S. Medical college, Mumbai,( Dr. Nirmala Rege, Professor: Pharmacology) &#039;&#039;&#039;“Immunostimulatory Potential of Indian Medicinal Plants on Thymocytes of Swiss Albino Mice”&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
==Research Allowance==&lt;br /&gt;
&lt;br /&gt;
2017: CCTS Research Informatics Services Voucher for obtaining the National Readmission dataset - $1750&lt;br /&gt;
&lt;br /&gt;
2015: CCTS Research Informatics Services Voucher for obtaining the National Inpatient Sample dataset - $3590&lt;br /&gt;
&lt;br /&gt;
2009: Indian Council of Medical Research, Short Term Studentship (Pharmacology)&lt;br /&gt;
&lt;br /&gt;
==Publications==&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Full Publications&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2018: Foraker R, Guha A, Chang H, O’Brien E, Bower J, Crouser E, Rosamond W, Raman SV. Survival after MI in a Community Cohort Study: Contribution of Comorbidities in NSTEMI. Glob Heart. 2018 Feb 3. pii: S2211-8160(18)30002-4. (PMID: 29409724)&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Snider MJ, Boyd M, Afzal M, Badin A, Godara H, Liu Z, Tyler J, Weiss R, Kalbfleisch S, Augostini R, Hummel J, Houmsse M, Daoud EG. Initiation and Outcomes with Class Ic Antiarrhythmic Drug Therapy. Indian Pacing Electrophysiol J. 2017 Dec 7. pii: S0972-6292(17)30192-4. doi: 10.1016/j.ipej.2017.12.001. [Epub ahead of print] (PMID: 29225010)&lt;br /&gt;
&lt;br /&gt;
2017: Liu E, Guha A, Jia K, Ayers AM, Boudoulas KD, Bertino E, Franco V. Cardiogenic shock in a patient being treated with Atezolizumab for metastatic non-small cell lung cancer. Lung Cancer. 2017 Jul 29. pii: S0169-5002(17)30416-6. doi: 10.1016/j.lungcan.2017.07.028. [Epub ahead of print] (PMID: 28780994, 29292070)&lt;br /&gt;
&lt;br /&gt;
2017: Wiczer TE, Levine LB, Brumbaugh J, Coggins J, Zhao Q, Ruppert AS, Rogers K, McCoy A, Mousa L, Guha A, Maddocks K, Christian B, Andritsos LA, Jaglowski S, Devine S, Baiocchi R, Woyach J, Jones J, Grever M, Blum KA, Byrd JC, Awan FT: Incidence, Risk Factors, and Management of Atrial Fibrillation in Patients Receiving Ibrutinib for Hematologic Malignancies. Blood Adv. 2017 1:1739-1748; doi: 10.1182/bloodadvances.2017009720 (PMID: 29296820)&lt;br /&gt;
&lt;br /&gt;
2017: Dunleavy M, Guha A, Ernst K, Sullivan M, Voelkel AJ, Raman SV, Baker C, Dean S. Running without a vein: Congenital Absence of the Right Common Iliac Vein. Int J Cardiovasc Imaging. 2017. Accepted for publication.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Gao X, Dunleavy M, Liu E, Patel D, Fedorov VV, Daoud EG. Eleven-year trends of inpatient pacemaker implantation in patients diagnosed with sick sinus syndrome. J Cardiovasc Electrophysiol. 2017 May 4. doi: 10.1111/jce.13248. [Epub ahead of print] (PMID: 28471545)&lt;br /&gt;
&lt;br /&gt;
2016: Li N, Csepe TA, Hansen BJ, Sul LV, Kalyanasundaram A, Zakharkin SO, Zhao J, Guha A, Van Wagoner DR, Kilic A, Mohler PJ, Janssen PM, Biesiadecki BJ, Hummel JD, Weiss R, Fedorov VV: Adenosine-Induced Atrial Fibrillation: Localized Reentrant Drivers in Lateral Right Atria due to Heterogeneous Expression of Adenosine A1 Receptors and GIRK4 Subunits in the Human Heart. Circulation. 2016 Aug 9;134 (6):486-98. (PMID: 27462069)&lt;br /&gt;
&lt;br /&gt;
2016: O&#039;Connor PM, Guha A, Stilphen CA, Sun J, Jin C: Proton channels and renal hypertensive injury: a key piece of the Dahl salt-sensitive rat puzzle? Am J Physiol Regul Integr Comp Physiol. 2016 Feb 3:ajpregu.00115.2015. (PMID: 26843580)&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Merchen LA: Cerebral Cryptococcoma – but Why? J Kuwait Med Assoc. 2015 November. 47(4):346-347.&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Maddox WR, Colombo R, Nahman NS Jr, Kintziger KW, Waller JL, Diamond M, Murphy M, Kheda M, Litwin SE, Sorrentino RA. Evaluation Of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Heart Rhythm. 2015 Aug 4. pii: S1547-5271(15)01017-6. (PMID: 26253036)&lt;br /&gt;
&lt;br /&gt;
2015: Ayoola R, Guha A, Daram SR: Gastrointestinal Bleeding as the Initial Presentation of HIV/AIDS. Gastrointest Endosc. 2015 Apr 25. pii: S0016-5107(15)02117-3. (PMID: 25922245)&lt;br /&gt;
&lt;br /&gt;
2014: Jin C, Sun J, Stilphen CA, Smith SME, Ocasio H, Bermingham B, Darji S, Guha A, Patel R, Geurts AM, Jacob HJ, Lambert NA, O’Connor PM: HV1 ACTS AS A sodium SENSOR AND promotes superoxide production in medullary thick ascending limb of Dahl SALT-SENSITIVE rats. Hypertension. 2014 Sep; 64(3):541-50. (PMID: 24935944)&lt;br /&gt;
&lt;br /&gt;
2014: Murphy M, Krothapalli S, Cuellar J, Kanjanauthai S, Heeke B, Sharma P, Guha A, Barnes VA, Litwin S, Sharma G: Prognostic Value of Normal Stress Echocardiography in Obese Patients. J Obes. 2014 Aug; 2014:419724. (PMID: 25258682)&lt;br /&gt;
&lt;br /&gt;
2014: Guha A, Kulkarni HS: ATS Patient Series: What is Histoplasmosis? Am J of Resir Crit Care Med. 2012 Apr; 185:1–2.&lt;br /&gt;
&lt;br /&gt;
2012: Madhwal S, Goldberg J, Barcena J, Guha A, Gogate P, Cmolik B, Elgudin Y: An Unusual Cause of Acute Mitral Regurgitation: Idiopathic Hypereosinophilic Syndrome. Ann Tho Surg. 2012 Mar; 93(3):974-7. (PMID: 22364989).&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Published Abstracts&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Dunleavy M, Raman SV, Harfi TT. Left Atrial Appendage Enhancement Pattern on CT Pulmonary Venograms is Associated with Left Atrial Appendage Emptying Velocity as Measured by Doppler signal During Transesophageal Echocardiography. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Dunleavy M, Raman SV, Harfi TT. Cardiology Fellows Learning Curve and Inter-observer Variability in the Interpretation of the Left Atrial Appendage on Cardiac CT Pulmonary Venograms. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Dunleavy M, Raman SV, Harfi TT. Accuracy of Non-ECG Gated, Single Phase, Contrast-Enhanced Cardiac CT Pulmonary Venography in Left Atrial Appendage Thrombus Rule Out as compared to Transesophageal Echocardiogram. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Dunleavy M, Guha A, Raman SV, Harfi TT. Coronary Artery Calcification as Detected on Pre-Atrial Fibrillation Computed Tomography(CT) Pulmonary Venogram Helps Optimize Patient Selection for Statin Therapy in Patients with Atrial Fibrillation. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Liu E, Guha A, Dunleavy M, Obarski T. Is Upper Endoscopy Required in Cirrhotic Patients prior to TEE? Accepted for poster at American Society of Echocardiography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Buck B, Guha A, Arora S, Awan FT, Lopez-Mattei JC, Plana-Gomez JC, Oliviera G, Fradley M, Addison D. Survival of in-hospital cardiac arrest among cancer patients. Submitted to European Society of Cardiology 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Addison D, Derbala M, Wiczer TE, Byrd JC, Awan FT. Ventricular Arrhythmias in Patients Managed With Ibrutinib For Cancer Immunotherapy. Accepted for poster ACC 2018. J Am Coll Cardiol. March 2018; 71(11_S): doi: 10.1016/S0735-1097(18)30820-9&lt;br /&gt;
&lt;br /&gt;
2018: Briston D, Guha A, Zubizarreta N, Daniels C, Bradley E. Results From the WISH-ACHD Study: Women&#039;s Initiative in the Study of Hospitalizations in Adult Congenital Heart Disease. Accepted for oral presentation ACC 2018. March 2018; 71(11_S):10.1016/S0735-1097(18)31070-2&lt;br /&gt;
&lt;br /&gt;
2017: Okabe T, Buck B, Guha A, Gao X, Liu E, Dunleavy M, Haddad D, Daoud EG. Short- And Mid-term Hospitalization for Recurrence Of Atrial Fibrillation After Catheter Ablation In Obese Patients. Accepted for oral presentation at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A16417.&lt;br /&gt;
&lt;br /&gt;
2017: Buck B, Guha A, Gao X, Liu E, Dunleavy M, Haddad D, Daoud EG, Okabe T. CHA2DS2-Vasc Score Predicts 30-day Thromboembolic Risk after Cardioversion of Atrial Fibrillation. Accepted for poster at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A18484.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Dunleavy M, Asad SY, Gao X, Liu E, Haddad D, Baliga R, Awan F, Mehta L. 12 Year Trends In Out Of Hospital Cardiac Arrest In Patients With Cancer. Accepted for poster at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A15968.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Yuan Z, Gao X, Liu E, Dunleavy M, Derbala M, Efebera Y, Baliga R, Smith S. National Trends in Hospitalization of Patients with Diastolic Heart Failure and Concurrent Amyloidosis. Accepted for poster at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A11678.&lt;br /&gt;
&lt;br /&gt;
2017: Buck B, Guha A, Gao X, Haddad D, Liu E, Dunleavy M, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Acute Coronary Syndrome and Concurrent Amyloidosis. Accepted for poster at the European Heart Congress meeting 2017. Eur Heart J. 2017; 38 (S1): ehx504.P4690.&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Houmsse M, Snider M, Daoud EG. Exercise Testing in Patients Treated with Class IC Antiarrhythmic Drug. Accepted for poster at HRS 2017 meeting. Heart Rhythm. 2017; 14 (5S): S514–S563&lt;br /&gt;
&lt;br /&gt;
2017: Buck B, Guha A, Gao X, Awan F, Hofmeister C, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Atrial Fibrillation and Concurrent Amyloidosis. Accepted for poster at HRS 2017 meeting. Heart Rhythm. 2017; 14 (5S): S144–S234&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Xiang X, Patel D, Fedorov VV, Daoud EG: 11 year Trends and Utilization Patterns of Cardiac Implantable Electronic Devices in Patients Diagnosed With Sick Sinus Syndrome. Accepted for poster AHA 2016. Circulation. 2016;134: A12756.&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Bower JK, Foraker R, Smith S: Ventricular Tachycardia and Sick Sinus Syndrome in Neoplasia. Accepted for poster Heart Rhythm 2016. Heart Rhythm. 2016; 13 (5S): S340–S426&lt;br /&gt;
&lt;br /&gt;
2015: Murphy M, Guha A, Maddox WR, Waller J, Sorrentino RA, Diamond M, Nahman, NS Jr: Modified HASBLED bleeding risk score in dialysis patients with atrial fibrillation. Accepted for poster AHA 2015. Circulation. 2015; 132: A12014&lt;br /&gt;
&lt;br /&gt;
2014: Patel NJ, Deshmukh AJ, Guha A, Mitrani RD, Paydak H, Viles-Gonzales J, Kowalski M et al: Gender, Racial and Insurance disparities in the Cardiac Resynchronization Therapy: Trends over the last decade. Circulation. Accepted for poster AHA 2014. Circulation. 2014; 130:A206.&lt;br /&gt;
&lt;br /&gt;
2014: Deshmukh A, Deshmukh AJ, Guha A, Desimone CV, Joshi M et al: Utilization and Outcome of Therapeutic Hypothermia for Out of Hospital Cardiac Arrest. Accepted for poster AHA 2014. Circulation. 2014; 130:A19401.&lt;br /&gt;
&lt;br /&gt;
2014: Deshmukh A, Patel NJ, Deshmukh AJ, Guha A, Desimone CV, Joshi M et al: Seasonal Variation of Out of Hospital Cardiac Arrest. Accepted for poster AHA 2014. Circulation. 2014; 130:A51.&lt;br /&gt;
&lt;br /&gt;
2014: Maddox WR, Waller J, Guha A, J Cuellar J, Diamond M, Murphy M, Litwin S, Nahman NS Jr, Kheda M, Sorrentino R: A Dialysis-Specific Risk Stratification Score Improves Stroke Prediction in Dialysis Patients with Atrial Fibrillation. Accepted for poster AHA 2014. Circulation. 2014; 130:A17629.&lt;br /&gt;
&lt;br /&gt;
2014: Diamond M, Maddox WR, Waller J, Guha A, J Cuellar J, Murphy M, Litwin S, Kheda M, Sorrentino R, Nahman NS Jr: Risk Factors of Stroke or Mortality in and after 90 days of Atrial Fibrillation Diagnosis in Dialysis Patients. Accepted for poster ASN 2014. J Am Soc Nephrol. 2014; 25: FR-PO1029.&lt;br /&gt;
&lt;br /&gt;
2014: J Cuellar J, Waller J, Guha A, Diamond M, Sorrentino R, Murphy M, Litwin S, Nahman NS Jr, Kheda M, Maddox M: CHA2DS2VASc score predicts stroke in dialysis patients with atrial fibrillation. Accepted for oral presentation ACC 2014. J Am Coll Cardiol. 2014; 63(12_S): doi: 10.1016/S0735-1097(14)60297-7.&lt;br /&gt;
&lt;br /&gt;
2014: Murphy M, J Cuellar J, Waller J, Guha A, Diamond M, Sorrentino R, Litwin S, Nahman NS Jr, Kheda M, Maddox M: CHA2DS2VASc score predicts mortality in dialysis patients with atrial fibrillation. Accepted for poster ACC 2014. J Am Coll Cardiol. 2014; 63(12_S): doi: 10.1016/S0735-1097(14)60358-2.&lt;br /&gt;
&lt;br /&gt;
2014: Guha A, Sun J, O’Connor PM: Apical NH4Cl acts to reduce intracellular Na concentration in mTAL via cellular depolarization. Accepted for poster Experimental Biology 2014. FASEB J. April 2014 28:1098.6.&lt;br /&gt;
&lt;br /&gt;
2014: Maddox WR, Kintziger K, Colombo R, Guha A, Kheda M, Nahman NS Jr, Sorrentino R: Mortality Following Cardiac Implantable Electronic Device Infection in Dialysis Patients from the USRDS. Accepted for oral presentation Heart Rhythm 2014. Heart Rhythm. 2014; 11 (S5): AB28-03.&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Sorrentino RA, Ghaffari A, Colombo R, Ellington CL, Chebrolu P, Kheda M, Nahman Jr NS, Kintziger K : Non-traditional risk factors for myocardial infarction and systolic heart failure following kidney transplantation. Accepted for poster ESC 2013. Eur Heart J. 2013; 34 (S1): 312.&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Sorrentino RA, Colombo R, Kheda M, Nahman Jr NS, Kintziger K. Evaluation Of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Late breaking clinical trials/oral plenary presentation of Heart Rhythm. Heart Rhythm, May 2013; published online.&lt;br /&gt;
&lt;br /&gt;
2013: Maddox W, Kintziger K, Colombo R, Guha A, Kheda M, Nahman S, Sorrentino R: Risk of cardiac implantable electronic device infection in hemodialysis or peritoneal dialysis: evaluation of a large end stage renal disease database. Accepted for poster AHA 2013. Circulation. 2013; 128: A16808.&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman NS Jr, Kintziger K, Merchen T, Kheda M, Sorrentino R: Non-traditional risk factors for atrial fibrillation following kidney transplantation. Accepted for poster AHA 2013. Circulation. 2013; 128:A12632.&lt;br /&gt;
&lt;br /&gt;
2013: Ghaffari A, Ellington CL, Colombo R, Baer S, Huber L, Guha A, Whitlow M, Chebrolu P, Nahman Jr NS, Kintziger K, Merchen T: Vasculopathic risk factors for delayed graft function in kidney transplantation. Accepted for poster at American Transplant Congress 2013. Amer J Transplant. 2013; 13 (S5):525.&lt;br /&gt;
&lt;br /&gt;
2012: Madhwal S, Guha A, Atreja A, Gupta P, Albeldawdi M, Post A, Costa A: Is Metabolic syndrome post Liver Transplantation a Risk Factor for Cardiovascular Disease? Accepted for poster AHA 2013. Circulation. 2012; 126: A18429.&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Poster/Online Presentations (published and unpublished)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Cardona A, Nagaraja HN, Raman SV, Zareba KM. Prognostic value of midwall fibrosis in patients with preserved ejection fraction and structurally normal heart (pilot study). Accepted for poster at CMR 2018, Barcelona, Spain. Published online - &amp;lt;nowiki&amp;gt;http://cmr2018.org/wp-content/uploads/2018/01/Abstract-Supplement-Book.pdf&amp;lt;/nowiki&amp;gt;&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Okabe T, Buck B, Gao X, Liu E, Dunleavy M, Haddad D, Daoud EG. Short- And Mid-term Hospitalization for Recurrence Of Atrial Fibrillation After Catheter Ablation In Obese Patients. (2017 November) American Association of Cardiologist of Indian Origin Annual Meeting, Anaheim, California, USA. Unpublished.&lt;br /&gt;
&lt;br /&gt;
2017: Franco DA, Gao X, Guha A, Buck B, Patel D, Snider MJ, Boyd M, Afzal M, Badin A, Godara H, Liu Z, Tyler J, Weiss R, Kalbfleisch S, Augostini R, Hummel J, Houmsse M, Daoud EG. Initiation and Outcomes with Class Ic Antiarrhythmic Drug Therapy. (2017 October) Ohio ACC meeting, Columbus, Ohio, USA. Unpublished.&lt;br /&gt;
&lt;br /&gt;
2017: Briston D, Guha A, Zubizarreta N, Daniels C, Bradley EA. Pregnancy in Congenital Heart Disease: Analysis of Maternal Cardiovascular Hospitalizations. (2017 September) Annual International Symposium on Adult Congenital Heart Disease, Cincinnati, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Dunleavy M, Guha A, Ernst K, Sullivan M, Voelkel AJ, Raman SV, Baker C, Dean S. Running without a vein: Congenital Absence of the Right Common Iliac Vein. (2017 June) NASCI Case in Point. Accepted for online publication.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Gao X, Dunleavy M, Liu E, Patel D, Fedorov VV, Daoud EG. Eleven year trends of inpatient pacemaker implantation in patients diagnosed with sick sinus syndrome. (2017 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Houmsse M, Snider M, Daoud EG. Exercise Testing in Patients Treated with Class IC Antiarrhythmic Drug. (2017 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Gao X, Awan F, Hofmeister C, Daoud EG, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Atrial Fibrillation and Concurrent Amyloidosis. (2017 April): OSUCCC – James Annual Scientific Meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Chang H, O’Brien E, Bower J, Crouser E, Rosamond W, Raman SV, Foraker R. Community-based mortality risk due to acute coronary syndromes: An ARIC study. (2016 October): Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Bower JK, Foraker R, Smith S. Ventricular Tachycardia and Sick Sinus Syndrome in Neoplasia. (2016 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Dooling PC, Ramsey ML, Guha A, Sofowora G. Connective Tissue Disease Presenting as Pericardial Effusion with Tamponade. (2016 May) OSU Internal Medicine Research day, Case Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Ruden E, Raman S. Unusual cardiac iron overload in a sickle cell disease patient. (2015 October): Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2014: Baker S, Guha A, Mitulescu L, Murphy M, Cuomo J, Haydour Q, Sorrentino RA. (October 2014). Slow Excitation: The remarkable presentation of Wolff-Parkinson-White Anomaly with bradycardia: Georgia ACP meeting; Lake Lanier, Georgia, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman Jr NS, Kintziger K, Kheda M, Sorrentino RA. (November 2013). Evaluation of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Oral Presentation presented at: Georgia ACC fellows presentation; Lake Oconee, Georgia USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
==Oral Presentations==&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Gao X, Haddad D, Liu E, Dunleavy M, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Acute Coronary Syndrome and Concurrent Amyloidosis. (2017 October) Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A. Sinoatrial node: Bench to bedside: OSU Cardiology Grand Rounds, Columbus, Ohio, USA. (2016 February) Unpublished&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman Jr NS, Kintziger K, Kheda M, Sorrentino RA. Evaluation of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. (May 2013). &#039;&#039;&#039;Oral Presentation presented at: Heart Rhythm Society. Late Breaking Clinical Tria&#039;&#039;&#039;l; Denver, Colorado USA. Published&lt;br /&gt;
&lt;br /&gt;
2008: Guha A, Vaidya V, Shah M, Sanghai S, Shukla E, Parikh R, Gala P, Shingada A, Goray A, Mansukhani S, Shah V. (2008, March). &#039;&#039;&#039;Phantom limb and the role of Virtual Mirror Box.&#039;&#039;&#039; Oral Presentation presented at: &#039;&#039;Bombay Medical Congress; Mumbai&#039;&#039;, India.&lt;br /&gt;
&lt;br /&gt;
2007: Guha A, Agarwal A, Sawant A, Surekha S, Krishnamoorty S et al. (2007, March). &#039;&#039;&#039;Paediatric HIV.&#039;&#039;&#039; Oral Presentation presented at: &#039;&#039;Bombay Medical Congress&#039;&#039;; Mumbai, India.&lt;br /&gt;
&lt;br /&gt;
==Editorial Boards==&lt;br /&gt;
&lt;br /&gt;
Associate Editor in Chief for [[Ventricular Tachycardia]] Section of wikidoc&lt;br /&gt;
&lt;br /&gt;
==Internet Educational Sites==&lt;br /&gt;
&lt;br /&gt;
Sharing information about boards and good literature is my passion http://www.avirupguha.co.nr&lt;br /&gt;
&lt;br /&gt;
[[Category:Medical Graduate]]&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=User:Avirupguha&amp;diff=1464118</id>
		<title>User:Avirupguha</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=User:Avirupguha&amp;diff=1464118"/>
		<updated>2018-04-19T13:17:35Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;&#039;&#039;&#039;Avirup Guha, M.B.B.S.&#039;&#039;&#039;, Associate Editor-in-Chief of [[Ventricular Tachycardia]], WikiDoc Foundation&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Contact:&#039;&#039;&#039; mailto:avirup.guha@gmail.com; &lt;br /&gt;
&lt;br /&gt;
__NOTOC__&lt;br /&gt;
----&lt;br /&gt;
Hi everyone coming to my page. I am Avirup Guha, a cardiology fellow at Ohio state University. My subjects of interest – Cardiology, Cardio-oncology and cardiac MRI&lt;br /&gt;
&lt;br /&gt;
==Education==&lt;br /&gt;
&lt;br /&gt;
2015 July – Present : Cardiology Fellowship, The Ohio State University&lt;br /&gt;
&lt;br /&gt;
Proficiency achievement goal by end of training:&lt;br /&gt;
&lt;br /&gt;
1. Cardiac CT – level 2&lt;br /&gt;
&lt;br /&gt;
2. Vascular imaging – level 2&lt;br /&gt;
&lt;br /&gt;
3. Echo – level 3 – board certified&lt;br /&gt;
&lt;br /&gt;
4. Nuclear – level 2 – board certified&lt;br /&gt;
&lt;br /&gt;
2012 July – 2015 June: Internal Medicine Residency, Board Certified, Georgia Regents University&lt;br /&gt;
&lt;br /&gt;
2005 August – 2011 May: Medical School, M.B.B.S., Seth G.S. Medical College, Mumbai, India&lt;br /&gt;
&lt;br /&gt;
==Research==&lt;br /&gt;
&lt;br /&gt;
2009: June—November Seth G.S. Medical college, Mumbai,( Dr. Shobna Bhatia, Head of the Department: Department of Gastroenterology) &#039;&#039;&#039;&amp;quot;Quality of nutrition, especially medium chain fatty acids, in patients of alcoholic liver disease as compared to alcoholics without liver disease&amp;quot;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2008: January—2009: October Seth G.S. Medical college, Mumbai,( Dr. Prafulla Kerkar, Head of the Department: Department of Cardiology) &#039;&#039;&#039;“To study the clinical profile and predictors of recurrence in patients with Stable Ventricular Tachycardia”&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2006: September—2007: March Seth G.S. Medical college, Mumbai,( Dr. Nirmala Rege, Professor: Pharmacology) &#039;&#039;&#039;“Immunostimulatory Potential of Indian Medicinal Plants on Thymocytes of Swiss Albino Mice”&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
==Research Allowance==&lt;br /&gt;
&lt;br /&gt;
2009: Indian Council of Medical Research, Short Term Studentship (Pharmacology)&lt;br /&gt;
&lt;br /&gt;
==Publications==&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Full Publications&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2018: Foraker R, Guha A, Chang H, O’Brien E, Bower J, Crouser E, Rosamond W, Raman SV. Survival after MI in a Community Cohort Study: Contribution of Comorbidities in NSTEMI. Glob Heart. 2018 Feb 3. pii: S2211-8160(18)30002-4. (PMID: 29409724)&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Snider MJ, Boyd M, Afzal M, Badin A, Godara H, Liu Z, Tyler J, Weiss R, Kalbfleisch S, Augostini R, Hummel J, Houmsse M, Daoud EG. Initiation and Outcomes with Class Ic Antiarrhythmic Drug Therapy. Indian Pacing Electrophysiol J. 2017 Dec 7. pii: S0972-6292(17)30192-4. doi: 10.1016/j.ipej.2017.12.001. [Epub ahead of print] (PMID: 29225010)&lt;br /&gt;
&lt;br /&gt;
2017: Liu E, Guha A, Jia K, Ayers AM, Boudoulas KD, Bertino E, Franco V. Cardiogenic shock in a patient being treated with Atezolizumab for metastatic non-small cell lung cancer. Lung Cancer. 2017 Jul 29. pii: S0169-5002(17)30416-6. doi: 10.1016/j.lungcan.2017.07.028. [Epub ahead of print] (PMID: 28780994, 29292070)&lt;br /&gt;
&lt;br /&gt;
2017: Wiczer TE, Levine LB, Brumbaugh J, Coggins J, Zhao Q, Ruppert AS, Rogers K, McCoy A, Mousa L, Guha A, Maddocks K, Christian B, Andritsos LA, Jaglowski S, Devine S, Baiocchi R, Woyach J, Jones J, Grever M, Blum KA, Byrd JC, Awan FT: Incidence, Risk Factors, and Management of Atrial Fibrillation in Patients Receiving Ibrutinib for Hematologic Malignancies. Blood Adv. 2017 1:1739-1748; doi: 10.1182/bloodadvances.2017009720 (PMID: 29296820)&lt;br /&gt;
&lt;br /&gt;
2017: Dunleavy M, Guha A, Ernst K, Sullivan M, Voelkel AJ, Raman SV, Baker C, Dean S. Running without a vein: Congenital Absence of the Right Common Iliac Vein. Int J Cardiovasc Imaging. 2017. Accepted for publication.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Gao X, Dunleavy M, Liu E, Patel D, Fedorov VV, Daoud EG. Eleven-year trends of inpatient pacemaker implantation in patients diagnosed with sick sinus syndrome. J Cardiovasc Electrophysiol. 2017 May 4. doi: 10.1111/jce.13248. [Epub ahead of print] (PMID: 28471545)&lt;br /&gt;
&lt;br /&gt;
2016: Li N, Csepe TA, Hansen BJ, Sul LV, Kalyanasundaram A, Zakharkin SO, Zhao J, Guha A, Van Wagoner DR, Kilic A, Mohler PJ, Janssen PM, Biesiadecki BJ, Hummel JD, Weiss R, Fedorov VV: Adenosine-Induced Atrial Fibrillation: Localized Reentrant Drivers in Lateral Right Atria due to Heterogeneous Expression of Adenosine A1 Receptors and GIRK4 Subunits in the Human Heart. Circulation. 2016 Aug 9;134 (6):486-98. (PMID: 27462069)&lt;br /&gt;
&lt;br /&gt;
2016: O&#039;Connor PM, Guha A, Stilphen CA, Sun J, Jin C: Proton channels and renal hypertensive injury: a key piece of the Dahl salt-sensitive rat puzzle? Am J Physiol Regul Integr Comp Physiol. 2016 Feb 3:ajpregu.00115.2015. (PMID: 26843580)&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Merchen LA: Cerebral Cryptococcoma – but Why? J Kuwait Med Assoc. 2015 November. 47(4):346-347.&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Maddox WR, Colombo R, Nahman NS Jr, Kintziger KW, Waller JL, Diamond M, Murphy M, Kheda M, Litwin SE, Sorrentino RA. Evaluation Of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Heart Rhythm. 2015 Aug 4. pii: S1547-5271(15)01017-6. (PMID: 26253036)&lt;br /&gt;
&lt;br /&gt;
2015: Ayoola R, Guha A, Daram SR: Gastrointestinal Bleeding as the Initial Presentation of HIV/AIDS. Gastrointest Endosc. 2015 Apr 25. pii: S0016-5107(15)02117-3. (PMID: 25922245)&lt;br /&gt;
&lt;br /&gt;
2014: Jin C, Sun J, Stilphen CA, Smith SME, Ocasio H, Bermingham B, Darji S, Guha A, Patel R, Geurts AM, Jacob HJ, Lambert NA, O’Connor PM: HV1 ACTS AS A sodium SENSOR AND promotes superoxide production in medullary thick ascending limb of Dahl SALT-SENSITIVE rats. Hypertension. 2014 Sep; 64(3):541-50. (PMID: 24935944)&lt;br /&gt;
&lt;br /&gt;
2014: Murphy M, Krothapalli S, Cuellar J, Kanjanauthai S, Heeke B, Sharma P, Guha A, Barnes VA, Litwin S, Sharma G: Prognostic Value of Normal Stress Echocardiography in Obese Patients. J Obes. 2014 Aug; 2014:419724. (PMID: 25258682)&lt;br /&gt;
&lt;br /&gt;
2014: Guha A, Kulkarni HS: ATS Patient Series: What is Histoplasmosis? Am J of Resir Crit Care Med. 2012 Apr; 185:1–2.&lt;br /&gt;
&lt;br /&gt;
2012: Madhwal S, Goldberg J, Barcena J, Guha A, Gogate P, Cmolik B, Elgudin Y: An Unusual Cause of Acute Mitral Regurgitation: Idiopathic Hypereosinophilic Syndrome. Ann Tho Surg. 2012 Mar; 93(3):974-7. (PMID: 22364989).&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Published Abstracts&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Dunleavy M, Raman SV, Harfi TT. Left Atrial Appendage Enhancement Pattern on CT Pulmonary Venograms is Associated with Left Atrial Appendage Emptying Velocity as Measured by Doppler signal During Transesophageal Echocardiography. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Dunleavy M, Raman SV, Harfi TT. Cardiology Fellows Learning Curve and Inter-observer Variability in the Interpretation of the Left Atrial Appendage on Cardiac CT Pulmonary Venograms. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Dunleavy M, Raman SV, Harfi TT. Accuracy of Non-ECG Gated, Single Phase, Contrast-Enhanced Cardiac CT Pulmonary Venography in Left Atrial Appendage Thrombus Rule Out as compared to Transesophageal Echocardiogram. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Dunleavy M, Guha A, Raman SV, Harfi TT. Coronary Artery Calcification as Detected on Pre-Atrial Fibrillation Computed Tomography(CT) Pulmonary Venogram Helps Optimize Patient Selection for Statin Therapy in Patients with Atrial Fibrillation. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Liu E, Guha A, Dunleavy M, Obarski T. Is Upper Endoscopy Required in Cirrhotic Patients prior to TEE? Accepted for poster at American Society of Echocardiography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Buck B, Guha A, Arora S, Awan FT, Lopez-Mattei JC, Plana-Gomez JC, Oliviera G, Fradley M, Addison D. Survival of in-hospital cardiac arrest among cancer patients. Submitted to European Society of Cardiology 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Addison D, Derbala M, Wiczer TE, Byrd JC, Awan FT. Ventricular Arrhythmias in Patients Managed With Ibrutinib For Cancer Immunotherapy. Accepted for poster ACC 2018. J Am Coll Cardiol. March 2018; 71(11_S): doi: 10.1016/S0735-1097(18)30820-9&lt;br /&gt;
&lt;br /&gt;
2018: Briston D, Guha A, Zubizarreta N, Daniels C, Bradley E. Results From the WISH-ACHD Study: Women&#039;s Initiative in the Study of Hospitalizations in Adult Congenital Heart Disease. Accepted for oral presentation ACC 2018. March 2018; 71(11_S):10.1016/S0735-1097(18)31070-2&lt;br /&gt;
&lt;br /&gt;
2017: Okabe T, Buck B, Guha A, Gao X, Liu E, Dunleavy M, Haddad D, Daoud EG. Short- And Mid-term Hospitalization for Recurrence Of Atrial Fibrillation After Catheter Ablation In Obese Patients. Accepted for oral presentation at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A16417.&lt;br /&gt;
&lt;br /&gt;
2017: Buck B, Guha A, Gao X, Liu E, Dunleavy M, Haddad D, Daoud EG, Okabe T. CHA2DS2-Vasc Score Predicts 30-day Thromboembolic Risk after Cardioversion of Atrial Fibrillation. Accepted for poster at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A18484.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Dunleavy M, Asad SY, Gao X, Liu E, Haddad D, Baliga R, Awan F, Mehta L. 12 Year Trends In Out Of Hospital Cardiac Arrest In Patients With Cancer. Accepted for poster at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A15968.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Yuan Z, Gao X, Liu E, Dunleavy M, Derbala M, Efebera Y, Baliga R, Smith S. National Trends in Hospitalization of Patients with Diastolic Heart Failure and Concurrent Amyloidosis. Accepted for poster at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A11678.&lt;br /&gt;
&lt;br /&gt;
2017: Buck B, Guha A, Gao X, Haddad D, Liu E, Dunleavy M, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Acute Coronary Syndrome and Concurrent Amyloidosis. Accepted for poster at the European Heart Congress meeting 2017. Eur Heart J. 2017; 38 (S1): ehx504.P4690.&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Houmsse M, Snider M, Daoud EG. Exercise Testing in Patients Treated with Class IC Antiarrhythmic Drug. Accepted for poster at HRS 2017 meeting. Heart Rhythm. 2017; 14 (5S): S514–S563&lt;br /&gt;
&lt;br /&gt;
2017: Buck B, Guha A, Gao X, Awan F, Hofmeister C, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Atrial Fibrillation and Concurrent Amyloidosis. Accepted for poster at HRS 2017 meeting. Heart Rhythm. 2017; 14 (5S): S144–S234&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Xiang X, Patel D, Fedorov VV, Daoud EG: 11 year Trends and Utilization Patterns of Cardiac Implantable Electronic Devices in Patients Diagnosed With Sick Sinus Syndrome. Accepted for poster AHA 2016. Circulation. 2016;134: A12756.&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Bower JK, Foraker R, Smith S: Ventricular Tachycardia and Sick Sinus Syndrome in Neoplasia. Accepted for poster Heart Rhythm 2016. Heart Rhythm. 2016; 13 (5S): S340–S426&lt;br /&gt;
&lt;br /&gt;
2015: Murphy M, Guha A, Maddox WR, Waller J, Sorrentino RA, Diamond M, Nahman, NS Jr: Modified HASBLED bleeding risk score in dialysis patients with atrial fibrillation. Accepted for poster AHA 2015. Circulation. 2015; 132: A12014&lt;br /&gt;
&lt;br /&gt;
2014: Patel NJ, Deshmukh AJ, Guha A, Mitrani RD, Paydak H, Viles-Gonzales J, Kowalski M et al: Gender, Racial and Insurance disparities in the Cardiac Resynchronization Therapy: Trends over the last decade. Circulation. Accepted for poster AHA 2014. Circulation. 2014; 130:A206.&lt;br /&gt;
&lt;br /&gt;
2014: Deshmukh A, Deshmukh AJ, Guha A, Desimone CV, Joshi M et al: Utilization and Outcome of Therapeutic Hypothermia for Out of Hospital Cardiac Arrest. Accepted for poster AHA 2014. Circulation. 2014; 130:A19401.&lt;br /&gt;
&lt;br /&gt;
2014: Deshmukh A, Patel NJ, Deshmukh AJ, Guha A, Desimone CV, Joshi M et al: Seasonal Variation of Out of Hospital Cardiac Arrest. Accepted for poster AHA 2014. Circulation. 2014; 130:A51.&lt;br /&gt;
&lt;br /&gt;
2014: Maddox WR, Waller J, Guha A, J Cuellar J, Diamond M, Murphy M, Litwin S, Nahman NS Jr, Kheda M, Sorrentino R: A Dialysis-Specific Risk Stratification Score Improves Stroke Prediction in Dialysis Patients with Atrial Fibrillation. Accepted for poster AHA 2014. Circulation. 2014; 130:A17629.&lt;br /&gt;
&lt;br /&gt;
2014: Diamond M, Maddox WR, Waller J, Guha A, J Cuellar J, Murphy M, Litwin S, Kheda M, Sorrentino R, Nahman NS Jr: Risk Factors of Stroke or Mortality in and after 90 days of Atrial Fibrillation Diagnosis in Dialysis Patients. Accepted for poster ASN 2014. J Am Soc Nephrol. 2014; 25: FR-PO1029.&lt;br /&gt;
&lt;br /&gt;
2014: J Cuellar J, Waller J, Guha A, Diamond M, Sorrentino R, Murphy M, Litwin S, Nahman NS Jr, Kheda M, Maddox M: CHA2DS2VASc score predicts stroke in dialysis patients with atrial fibrillation. Accepted for oral presentation ACC 2014. J Am Coll Cardiol. 2014; 63(12_S): doi: 10.1016/S0735-1097(14)60297-7.&lt;br /&gt;
&lt;br /&gt;
2014: Murphy M, J Cuellar J, Waller J, Guha A, Diamond M, Sorrentino R, Litwin S, Nahman NS Jr, Kheda M, Maddox M: CHA2DS2VASc score predicts mortality in dialysis patients with atrial fibrillation. Accepted for poster ACC 2014. J Am Coll Cardiol. 2014; 63(12_S): doi: 10.1016/S0735-1097(14)60358-2.&lt;br /&gt;
&lt;br /&gt;
2014: Guha A, Sun J, O’Connor PM: Apical NH4Cl acts to reduce intracellular Na concentration in mTAL via cellular depolarization. Accepted for poster Experimental Biology 2014. FASEB J. April 2014 28:1098.6.&lt;br /&gt;
&lt;br /&gt;
2014: Maddox WR, Kintziger K, Colombo R, Guha A, Kheda M, Nahman NS Jr, Sorrentino R: Mortality Following Cardiac Implantable Electronic Device Infection in Dialysis Patients from the USRDS. Accepted for oral presentation Heart Rhythm 2014. Heart Rhythm. 2014; 11 (S5): AB28-03.&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Sorrentino RA, Ghaffari A, Colombo R, Ellington CL, Chebrolu P, Kheda M, Nahman Jr NS, Kintziger K : Non-traditional risk factors for myocardial infarction and systolic heart failure following kidney transplantation. Accepted for poster ESC 2013. Eur Heart J. 2013; 34 (S1): 312.&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Sorrentino RA, Colombo R, Kheda M, Nahman Jr NS, Kintziger K. Evaluation Of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Late breaking clinical trials/oral plenary presentation of Heart Rhythm. Heart Rhythm, May 2013; published online.&lt;br /&gt;
&lt;br /&gt;
2013: Maddox W, Kintziger K, Colombo R, Guha A, Kheda M, Nahman S, Sorrentino R: Risk of cardiac implantable electronic device infection in hemodialysis or peritoneal dialysis: evaluation of a large end stage renal disease database. Accepted for poster AHA 2013. Circulation. 2013; 128: A16808.&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman NS Jr, Kintziger K, Merchen T, Kheda M, Sorrentino R: Non-traditional risk factors for atrial fibrillation following kidney transplantation. Accepted for poster AHA 2013. Circulation. 2013; 128:A12632.&lt;br /&gt;
&lt;br /&gt;
2013: Ghaffari A, Ellington CL, Colombo R, Baer S, Huber L, Guha A, Whitlow M, Chebrolu P, Nahman Jr NS, Kintziger K, Merchen T: Vasculopathic risk factors for delayed graft function in kidney transplantation. Accepted for poster at American Transplant Congress 2013. Amer J Transplant. 2013; 13 (S5):525.&lt;br /&gt;
&lt;br /&gt;
2012: Madhwal S, Guha A, Atreja A, Gupta P, Albeldawdi M, Post A, Costa A: Is Metabolic syndrome post Liver Transplantation a Risk Factor for Cardiovascular Disease? Accepted for poster AHA 2013. Circulation. 2012; 126: A18429.&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Poster/Online Presentations (published and unpublished)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Cardona A, Nagaraja HN, Raman SV, Zareba KM. Prognostic value of midwall fibrosis in patients with preserved ejection fraction and structurally normal heart (pilot study). Accepted for poster at CMR 2018, Barcelona, Spain. Published online - &amp;lt;nowiki&amp;gt;http://cmr2018.org/wp-content/uploads/2018/01/Abstract-Supplement-Book.pdf&amp;lt;/nowiki&amp;gt;&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Okabe T, Buck B, Gao X, Liu E, Dunleavy M, Haddad D, Daoud EG. Short- And Mid-term Hospitalization for Recurrence Of Atrial Fibrillation After Catheter Ablation In Obese Patients. (2017 November) American Association of Cardiologist of Indian Origin Annual Meeting, Anaheim, California, USA. Unpublished.&lt;br /&gt;
&lt;br /&gt;
2017: Franco DA, Gao X, Guha A, Buck B, Patel D, Snider MJ, Boyd M, Afzal M, Badin A, Godara H, Liu Z, Tyler J, Weiss R, Kalbfleisch S, Augostini R, Hummel J, Houmsse M, Daoud EG. Initiation and Outcomes with Class Ic Antiarrhythmic Drug Therapy. (2017 October) Ohio ACC meeting, Columbus, Ohio, USA. Unpublished.&lt;br /&gt;
&lt;br /&gt;
2017: Briston D, Guha A, Zubizarreta N, Daniels C, Bradley EA. Pregnancy in Congenital Heart Disease: Analysis of Maternal Cardiovascular Hospitalizations. (2017 September) Annual International Symposium on Adult Congenital Heart Disease, Cincinnati, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Dunleavy M, Guha A, Ernst K, Sullivan M, Voelkel AJ, Raman SV, Baker C, Dean S. Running without a vein: Congenital Absence of the Right Common Iliac Vein. (2017 June) NASCI Case in Point. Accepted for online publication.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Gao X, Dunleavy M, Liu E, Patel D, Fedorov VV, Daoud EG. Eleven year trends of inpatient pacemaker implantation in patients diagnosed with sick sinus syndrome. (2017 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Houmsse M, Snider M, Daoud EG. Exercise Testing in Patients Treated with Class IC Antiarrhythmic Drug. (2017 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Gao X, Awan F, Hofmeister C, Daoud EG, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Atrial Fibrillation and Concurrent Amyloidosis. (2017 April): OSUCCC – James Annual Scientific Meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Chang H, O’Brien E, Bower J, Crouser E, Rosamond W, Raman SV, Foraker R. Community-based mortality risk due to acute coronary syndromes: An ARIC study. (2016 October): Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Bower JK, Foraker R, Smith S. Ventricular Tachycardia and Sick Sinus Syndrome in Neoplasia. (2016 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Dooling PC, Ramsey ML, Guha A, Sofowora G. Connective Tissue Disease Presenting as Pericardial Effusion with Tamponade. (2016 May) OSU Internal Medicine Research day, Case Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Ruden E, Raman S. Unusual cardiac iron overload in a sickle cell disease patient. (2015 October): Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2014: Baker S, Guha A, Mitulescu L, Murphy M, Cuomo J, Haydour Q, Sorrentino RA. (October 2014). Slow Excitation: The remarkable presentation of Wolff-Parkinson-White Anomaly with bradycardia: Georgia ACP meeting; Lake Lanier, Georgia, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman Jr NS, Kintziger K, Kheda M, Sorrentino RA. (November 2013). Evaluation of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Oral Presentation presented at: Georgia ACC fellows presentation; Lake Oconee, Georgia USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
==Oral Presentations==&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Gao X, Haddad D, Liu E, Dunleavy M, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Acute Coronary Syndrome and Concurrent Amyloidosis. (2017 October) Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A. Sinoatrial node: Bench to bedside: OSU Cardiology Grand Rounds, Columbus, Ohio, USA. (2016 February) Unpublished&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman Jr NS, Kintziger K, Kheda M, Sorrentino RA. Evaluation of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. (May 2013). &#039;&#039;&#039;Oral Presentation presented at: Heart Rhythm Society. Late Breaking Clinical Tria&#039;&#039;&#039;l; Denver, Colorado USA. Published&lt;br /&gt;
&lt;br /&gt;
2008: Guha A, Vaidya V, Shah M, Sanghai S, Shukla E, Parikh R, Gala P, Shingada A, Goray A, Mansukhani S, Shah V. (2008, March). &#039;&#039;&#039;Phantom limb and the role of Virtual Mirror Box.&#039;&#039;&#039; Oral Presentation presented at: &#039;&#039;Bombay Medical Congress; Mumbai&#039;&#039;, India.&lt;br /&gt;
&lt;br /&gt;
2007: Guha A, Agarwal A, Sawant A, Surekha S, Krishnamoorty S et al. (2007, March). &#039;&#039;&#039;Paediatric HIV.&#039;&#039;&#039; Oral Presentation presented at: &#039;&#039;Bombay Medical Congress&#039;&#039;; Mumbai, India.&lt;br /&gt;
&lt;br /&gt;
==Editorial Boards==&lt;br /&gt;
&lt;br /&gt;
Associate Editor in Chief for [[Ventricular Tachycardia]] Section of wikidoc&lt;br /&gt;
&lt;br /&gt;
==Internet Educational Sites==&lt;br /&gt;
&lt;br /&gt;
Sharing information about boards and good literature is my passion http://www.avirupguha.co.nr&lt;br /&gt;
&lt;br /&gt;
[[Category:Medical Graduate]]&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=User:Avirupguha&amp;diff=1464115</id>
		<title>User:Avirupguha</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=User:Avirupguha&amp;diff=1464115"/>
		<updated>2018-04-19T13:11:06Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;&#039;&#039;&#039;Avirup Guha, M.B.B.S.&#039;&#039;&#039;, Associate Editor-in-Chief of [[Ventricular Tachycardia]], WikiDoc Foundation&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Contact:&#039;&#039;&#039; mailto:avirup.guha@gmail.com; &lt;br /&gt;
&lt;br /&gt;
__NOTOC__&lt;br /&gt;
----&lt;br /&gt;
Hi everyone coming to my page. I am Avirup Guha, a cardiology fellow at Ohio state University.&lt;br /&gt;
My subjects of interest – Cardiology, Cardio-oncology&lt;br /&gt;
&lt;br /&gt;
==Education==&lt;br /&gt;
&lt;br /&gt;
I finished my training from Seth G.S. Medical College, Mumbai, India. I passed out with M.B.B.S. degree in May 2011. I did around 8 months of rotations in various US institutions in varied environments for US clinical experience.&lt;br /&gt;
&lt;br /&gt;
==Research==&lt;br /&gt;
&lt;br /&gt;
2009: June—November Seth G.S. Medical college, Mumbai,( Dr. Shobna Bhatia, Head of the Department: Department of Gastroenterology) &#039;&#039;&#039;&amp;quot;Quality of nutrition, especially medium chain fatty acids, in patients of alcoholic liver disease as compared to alcoholics without liver disease&amp;quot;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2008: January—2009: October Seth G.S. Medical college, Mumbai,( Dr. Prafulla Kerkar, Head of the Department: Department of Cardiology) &#039;&#039;&#039;“To study the clinical profile and predictors of recurrence in patients with Stable Ventricular Tachycardia”&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2006: September—2007: March Seth G.S. Medical college, Mumbai,( Dr. Nirmala Rege, Professor: Pharmacology) &#039;&#039;&#039;“Immunostimulatory Potential of Indian Medicinal Plants on Thymocytes of Swiss Albino Mice”&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
==Research Allowance==&lt;br /&gt;
&lt;br /&gt;
2009: Indian Council of Medical Research, Short Term Studentship (Pharmacology)&lt;br /&gt;
&lt;br /&gt;
==Publications==&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Full Publications&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2018: Foraker R, Guha A, Chang H, O’Brien E, Bower J, Crouser E, Rosamond W, Raman SV. Survival after MI in a Community Cohort Study: Contribution of Comorbidities in NSTEMI. Glob Heart. 2018 Feb 3. pii: S2211-8160(18)30002-4. (PMID: 29409724)&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Snider MJ, Boyd M, Afzal M, Badin A, Godara H, Liu Z, Tyler J, Weiss R, Kalbfleisch S, Augostini R, Hummel J, Houmsse M, Daoud EG. Initiation and Outcomes with Class Ic Antiarrhythmic Drug Therapy. Indian Pacing Electrophysiol J. 2017 Dec 7. pii: S0972-6292(17)30192-4. doi: 10.1016/j.ipej.2017.12.001. [Epub ahead of print] (PMID: 29225010)&lt;br /&gt;
&lt;br /&gt;
2017: Liu E, Guha A, Jia K, Ayers AM, Boudoulas KD, Bertino E, Franco V. Cardiogenic shock in a patient being treated with Atezolizumab for metastatic non-small cell lung cancer. Lung Cancer. 2017 Jul 29. pii: S0169-5002(17)30416-6. doi: 10.1016/j.lungcan.2017.07.028. [Epub ahead of print] (PMID: 28780994, 29292070)&lt;br /&gt;
&lt;br /&gt;
2017: Wiczer TE, Levine LB, Brumbaugh J, Coggins J, Zhao Q, Ruppert AS, Rogers K, McCoy A, Mousa L, Guha A, Maddocks K, Christian B, Andritsos LA, Jaglowski S, Devine S, Baiocchi R, Woyach J, Jones J, Grever M, Blum KA, Byrd JC, Awan FT: Incidence, Risk Factors, and Management of Atrial Fibrillation in Patients Receiving Ibrutinib for Hematologic Malignancies. Blood Adv. 2017 1:1739-1748; doi: 10.1182/bloodadvances.2017009720 (PMID: 29296820)&lt;br /&gt;
&lt;br /&gt;
2017: Dunleavy M, Guha A, Ernst K, Sullivan M, Voelkel AJ, Raman SV, Baker C, Dean S. Running without a vein: Congenital Absence of the Right Common Iliac Vein. Int J Cardiovasc Imaging. 2017. Accepted for publication.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Gao X, Dunleavy M, Liu E, Patel D, Fedorov VV, Daoud EG. Eleven-year trends of inpatient pacemaker implantation in patients diagnosed with sick sinus syndrome. J Cardiovasc Electrophysiol. 2017 May 4. doi: 10.1111/jce.13248. [Epub ahead of print] (PMID: 28471545)&lt;br /&gt;
&lt;br /&gt;
2016: Li N, Csepe TA, Hansen BJ, Sul LV, Kalyanasundaram A, Zakharkin SO, Zhao J, Guha A, Van Wagoner DR, Kilic A, Mohler PJ, Janssen PM, Biesiadecki BJ, Hummel JD, Weiss R, Fedorov VV: Adenosine-Induced Atrial Fibrillation: Localized Reentrant Drivers in Lateral Right Atria due to Heterogeneous Expression of Adenosine A1 Receptors and GIRK4 Subunits in the Human Heart. Circulation. 2016 Aug 9;134 (6):486-98. (PMID: 27462069)&lt;br /&gt;
&lt;br /&gt;
2016: O&#039;Connor PM, Guha A, Stilphen CA, Sun J, Jin C: Proton channels and renal hypertensive injury: a key piece of the Dahl salt-sensitive rat puzzle? Am J Physiol Regul Integr Comp Physiol. 2016 Feb 3:ajpregu.00115.2015. (PMID: 26843580)&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Merchen LA: Cerebral Cryptococcoma – but Why? J Kuwait Med Assoc. 2015 November. 47(4):346-347.&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Maddox WR, Colombo R, Nahman NS Jr, Kintziger KW, Waller JL, Diamond M, Murphy M, Kheda M, Litwin SE, Sorrentino RA. Evaluation Of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Heart Rhythm. 2015 Aug 4. pii: S1547-5271(15)01017-6. (PMID: 26253036)&lt;br /&gt;
&lt;br /&gt;
2015: Ayoola R, Guha A, Daram SR: Gastrointestinal Bleeding as the Initial Presentation of HIV/AIDS. Gastrointest Endosc. 2015 Apr 25. pii: S0016-5107(15)02117-3. (PMID: 25922245)&lt;br /&gt;
&lt;br /&gt;
2014: Jin C, Sun J, Stilphen CA, Smith SME, Ocasio H, Bermingham B, Darji S, Guha A, Patel R, Geurts AM, Jacob HJ, Lambert NA, O’Connor PM: HV1 ACTS AS A sodium SENSOR AND promotes superoxide production in medullary thick ascending limb of Dahl SALT-SENSITIVE rats. Hypertension. 2014 Sep; 64(3):541-50. (PMID: 24935944)&lt;br /&gt;
&lt;br /&gt;
2014: Murphy M, Krothapalli S, Cuellar J, Kanjanauthai S, Heeke B, Sharma P, Guha A, Barnes VA, Litwin S, Sharma G: Prognostic Value of Normal Stress Echocardiography in Obese Patients. J Obes. 2014 Aug; 2014:419724. (PMID: 25258682)&lt;br /&gt;
&lt;br /&gt;
2014: Guha A, Kulkarni HS: ATS Patient Series: What is Histoplasmosis? Am J of Resir Crit Care Med. 2012 Apr; 185:1–2.&lt;br /&gt;
&lt;br /&gt;
2012: Madhwal S, Goldberg J, Barcena J, Guha A, Gogate P, Cmolik B, Elgudin Y: An Unusual Cause of Acute Mitral Regurgitation: Idiopathic Hypereosinophilic Syndrome. Ann Tho Surg. 2012 Mar; 93(3):974-7. (PMID: 22364989).&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Published Abstracts&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Dunleavy M, Raman SV, Harfi TT. Left Atrial Appendage Enhancement Pattern on CT Pulmonary Venograms is Associated with Left Atrial Appendage Emptying Velocity as Measured by Doppler signal During Transesophageal Echocardiography. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Dunleavy M, Raman SV, Harfi TT. Cardiology Fellows Learning Curve and Inter-observer Variability in the Interpretation of the Left Atrial Appendage on Cardiac CT Pulmonary Venograms. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Dunleavy M, Raman SV, Harfi TT. Accuracy of Non-ECG Gated, Single Phase, Contrast-Enhanced Cardiac CT Pulmonary Venography in Left Atrial Appendage Thrombus Rule Out as compared to Transesophageal Echocardiogram. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Dunleavy M, Guha A, Raman SV, Harfi TT. Coronary Artery Calcification as Detected on Pre-Atrial Fibrillation Computed Tomography(CT) Pulmonary Venogram Helps Optimize Patient Selection for Statin Therapy in Patients with Atrial Fibrillation. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Liu E, Guha A, Dunleavy M, Obarski T. Is Upper Endoscopy Required in Cirrhotic Patients prior to TEE? Accepted for poster at American Society of Echocardiography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Buck B, Guha A, Arora S, Awan FT, Lopez-Mattei JC, Plana-Gomez JC, Oliviera G, Fradley M, Addison D. Survival of in-hospital cardiac arrest among cancer patients. Submitted to European Society of Cardiology 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Addison D, Derbala M, Wiczer TE, Byrd JC, Awan FT. Ventricular Arrhythmias in Patients Managed With Ibrutinib For Cancer Immunotherapy. Accepted for poster ACC 2018. J Am Coll Cardiol. March 2018; 71(11_S): doi: 10.1016/S0735-1097(18)30820-9&lt;br /&gt;
&lt;br /&gt;
2018: Briston D, Guha A, Zubizarreta N, Daniels C, Bradley E. Results From the WISH-ACHD Study: Women&#039;s Initiative in the Study of Hospitalizations in Adult Congenital Heart Disease. Accepted for oral presentation ACC 2018. March 2018; 71(11_S):10.1016/S0735-1097(18)31070-2&lt;br /&gt;
&lt;br /&gt;
2017: Okabe T, Buck B, Guha A, Gao X, Liu E, Dunleavy M, Haddad D, Daoud EG. Short- And Mid-term Hospitalization for Recurrence Of Atrial Fibrillation After Catheter Ablation In Obese Patients. Accepted for oral presentation at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A16417.&lt;br /&gt;
&lt;br /&gt;
2017: Buck B, Guha A, Gao X, Liu E, Dunleavy M, Haddad D, Daoud EG, Okabe T. CHA2DS2-Vasc Score Predicts 30-day Thromboembolic Risk after Cardioversion of Atrial Fibrillation. Accepted for poster at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A18484.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Dunleavy M, Asad SY, Gao X, Liu E, Haddad D, Baliga R, Awan F, Mehta L. 12 Year Trends In Out Of Hospital Cardiac Arrest In Patients With Cancer. Accepted for poster at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A15968.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Yuan Z, Gao X, Liu E, Dunleavy M, Derbala M, Efebera Y, Baliga R, Smith S. National Trends in Hospitalization of Patients with Diastolic Heart Failure and Concurrent Amyloidosis. Accepted for poster at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A11678.&lt;br /&gt;
&lt;br /&gt;
2017: Buck B, Guha A, Gao X, Haddad D, Liu E, Dunleavy M, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Acute Coronary Syndrome and Concurrent Amyloidosis. Accepted for poster at the European Heart Congress meeting 2017. Eur Heart J. 2017; 38 (S1): ehx504.P4690.&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Houmsse M, Snider M, Daoud EG. Exercise Testing in Patients Treated with Class IC Antiarrhythmic Drug. Accepted for poster at HRS 2017 meeting. Heart Rhythm. 2017; 14 (5S): S514–S563&lt;br /&gt;
&lt;br /&gt;
2017: Buck B, Guha A, Gao X, Awan F, Hofmeister C, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Atrial Fibrillation and Concurrent Amyloidosis. Accepted for poster at HRS 2017 meeting. Heart Rhythm. 2017; 14 (5S): S144–S234&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Xiang X, Patel D, Fedorov VV, Daoud EG: 11 year Trends and Utilization Patterns of Cardiac Implantable Electronic Devices in Patients Diagnosed With Sick Sinus Syndrome. Accepted for poster AHA 2016. Circulation. 2016;134: A12756.&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Bower JK, Foraker R, Smith S: Ventricular Tachycardia and Sick Sinus Syndrome in Neoplasia. Accepted for poster Heart Rhythm 2016. Heart Rhythm. 2016; 13 (5S): S340–S426&lt;br /&gt;
&lt;br /&gt;
2015: Murphy M, Guha A, Maddox WR, Waller J, Sorrentino RA, Diamond M, Nahman, NS Jr: Modified HASBLED bleeding risk score in dialysis patients with atrial fibrillation. Accepted for poster AHA 2015. Circulation. 2015; 132: A12014&lt;br /&gt;
&lt;br /&gt;
2014: Patel NJ, Deshmukh AJ, Guha A, Mitrani RD, Paydak H, Viles-Gonzales J, Kowalski M et al: Gender, Racial and Insurance disparities in the Cardiac Resynchronization Therapy: Trends over the last decade. Circulation. Accepted for poster AHA 2014. Circulation. 2014; 130:A206.&lt;br /&gt;
&lt;br /&gt;
2014: Deshmukh A, Deshmukh AJ, Guha A, Desimone CV, Joshi M et al: Utilization and Outcome of Therapeutic Hypothermia for Out of Hospital Cardiac Arrest. Accepted for poster AHA 2014. Circulation. 2014; 130:A19401.&lt;br /&gt;
&lt;br /&gt;
2014: Deshmukh A, Patel NJ, Deshmukh AJ, Guha A, Desimone CV, Joshi M et al: Seasonal Variation of Out of Hospital Cardiac Arrest. Accepted for poster AHA 2014. Circulation. 2014; 130:A51.&lt;br /&gt;
&lt;br /&gt;
2014: Maddox WR, Waller J, Guha A, J Cuellar J, Diamond M, Murphy M, Litwin S, Nahman NS Jr, Kheda M, Sorrentino R: A Dialysis-Specific Risk Stratification Score Improves Stroke Prediction in Dialysis Patients with Atrial Fibrillation. Accepted for poster AHA 2014. Circulation. 2014; 130:A17629.&lt;br /&gt;
&lt;br /&gt;
2014: Diamond M, Maddox WR, Waller J, Guha A, J Cuellar J, Murphy M, Litwin S, Kheda M, Sorrentino R, Nahman NS Jr: Risk Factors of Stroke or Mortality in and after 90 days of Atrial Fibrillation Diagnosis in Dialysis Patients. Accepted for poster ASN 2014. J Am Soc Nephrol. 2014; 25: FR-PO1029.&lt;br /&gt;
&lt;br /&gt;
2014: J Cuellar J, Waller J, Guha A, Diamond M, Sorrentino R, Murphy M, Litwin S, Nahman NS Jr, Kheda M, Maddox M: CHA2DS2VASc score predicts stroke in dialysis patients with atrial fibrillation. Accepted for oral presentation ACC 2014. J Am Coll Cardiol. 2014; 63(12_S): doi: 10.1016/S0735-1097(14)60297-7.&lt;br /&gt;
&lt;br /&gt;
2014: Murphy M, J Cuellar J, Waller J, Guha A, Diamond M, Sorrentino R, Litwin S, Nahman NS Jr, Kheda M, Maddox M: CHA2DS2VASc score predicts mortality in dialysis patients with atrial fibrillation. Accepted for poster ACC 2014. J Am Coll Cardiol. 2014; 63(12_S): doi: 10.1016/S0735-1097(14)60358-2.&lt;br /&gt;
&lt;br /&gt;
2014: Guha A, Sun J, O’Connor PM: Apical NH4Cl acts to reduce intracellular Na concentration in mTAL via cellular depolarization. Accepted for poster Experimental Biology 2014. FASEB J. April 2014 28:1098.6.&lt;br /&gt;
&lt;br /&gt;
2014: Maddox WR, Kintziger K, Colombo R, Guha A, Kheda M, Nahman NS Jr, Sorrentino R: Mortality Following Cardiac Implantable Electronic Device Infection in Dialysis Patients from the USRDS. Accepted for oral presentation Heart Rhythm 2014. Heart Rhythm. 2014; 11 (S5): AB28-03.&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Sorrentino RA, Ghaffari A, Colombo R, Ellington CL, Chebrolu P, Kheda M, Nahman Jr NS, Kintziger K : Non-traditional risk factors for myocardial infarction and systolic heart failure following kidney transplantation. Accepted for poster ESC 2013. Eur Heart J. 2013; 34 (S1): 312.&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Sorrentino RA, Colombo R, Kheda M, Nahman Jr NS, Kintziger K. Evaluation Of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Late breaking clinical trials/oral plenary presentation of Heart Rhythm. Heart Rhythm, May 2013; published online.&lt;br /&gt;
&lt;br /&gt;
2013: Maddox W, Kintziger K, Colombo R, Guha A, Kheda M, Nahman S, Sorrentino R: Risk of cardiac implantable electronic device infection in hemodialysis or peritoneal dialysis: evaluation of a large end stage renal disease database. Accepted for poster AHA 2013. Circulation. 2013; 128: A16808.&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman NS Jr, Kintziger K, Merchen T, Kheda M, Sorrentino R: Non-traditional risk factors for atrial fibrillation following kidney transplantation. Accepted for poster AHA 2013. Circulation. 2013; 128:A12632.&lt;br /&gt;
&lt;br /&gt;
2013: Ghaffari A, Ellington CL, Colombo R, Baer S, Huber L, Guha A, Whitlow M, Chebrolu P, Nahman Jr NS, Kintziger K, Merchen T: Vasculopathic risk factors for delayed graft function in kidney transplantation. Accepted for poster at American Transplant Congress 2013. Amer J Transplant. 2013; 13 (S5):525.&lt;br /&gt;
&lt;br /&gt;
2012: Madhwal S, Guha A, Atreja A, Gupta P, Albeldawdi M, Post A, Costa A: Is Metabolic syndrome post Liver Transplantation a Risk Factor for Cardiovascular Disease? Accepted for poster AHA 2013. Circulation. 2012; 126: A18429.&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Poster/Online Presentations (published and unpublished)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Cardona A, Nagaraja HN, Raman SV, Zareba KM. Prognostic value of midwall fibrosis in patients with preserved ejection fraction and structurally normal heart (pilot study). Accepted for poster at CMR 2018, Barcelona, Spain. Published online - &amp;lt;nowiki&amp;gt;http://cmr2018.org/wp-content/uploads/2018/01/Abstract-Supplement-Book.pdf&amp;lt;/nowiki&amp;gt;&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Okabe T, Buck B, Gao X, Liu E, Dunleavy M, Haddad D, Daoud EG. Short- And Mid-term Hospitalization for Recurrence Of Atrial Fibrillation After Catheter Ablation In Obese Patients. (2017 November) American Association of Cardiologist of Indian Origin Annual Meeting, Anaheim, California, USA. Unpublished.&lt;br /&gt;
&lt;br /&gt;
2017: Franco DA, Gao X, Guha A, Buck B, Patel D, Snider MJ, Boyd M, Afzal M, Badin A, Godara H, Liu Z, Tyler J, Weiss R, Kalbfleisch S, Augostini R, Hummel J, Houmsse M, Daoud EG. Initiation and Outcomes with Class Ic Antiarrhythmic Drug Therapy. (2017 October) Ohio ACC meeting, Columbus, Ohio, USA. Unpublished.&lt;br /&gt;
&lt;br /&gt;
2017: Briston D, Guha A, Zubizarreta N, Daniels C, Bradley EA. Pregnancy in Congenital Heart Disease: Analysis of Maternal Cardiovascular Hospitalizations. (2017 September) Annual International Symposium on Adult Congenital Heart Disease, Cincinnati, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Dunleavy M, Guha A, Ernst K, Sullivan M, Voelkel AJ, Raman SV, Baker C, Dean S. Running without a vein: Congenital Absence of the Right Common Iliac Vein. (2017 June) NASCI Case in Point. Accepted for online publication.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Gao X, Dunleavy M, Liu E, Patel D, Fedorov VV, Daoud EG. Eleven year trends of inpatient pacemaker implantation in patients diagnosed with sick sinus syndrome. (2017 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Houmsse M, Snider M, Daoud EG. Exercise Testing in Patients Treated with Class IC Antiarrhythmic Drug. (2017 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Gao X, Awan F, Hofmeister C, Daoud EG, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Atrial Fibrillation and Concurrent Amyloidosis. (2017 April): OSUCCC – James Annual Scientific Meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Chang H, O’Brien E, Bower J, Crouser E, Rosamond W, Raman SV, Foraker R. Community-based mortality risk due to acute coronary syndromes: An ARIC study. (2016 October): Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Bower JK, Foraker R, Smith S. Ventricular Tachycardia and Sick Sinus Syndrome in Neoplasia. (2016 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Dooling PC, Ramsey ML, Guha A, Sofowora G. Connective Tissue Disease Presenting as Pericardial Effusion with Tamponade. (2016 May) OSU Internal Medicine Research day, Case Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Ruden E, Raman S. Unusual cardiac iron overload in a sickle cell disease patient. (2015 October): Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2014: Baker S, Guha A, Mitulescu L, Murphy M, Cuomo J, Haydour Q, Sorrentino RA. (October 2014). Slow Excitation: The remarkable presentation of Wolff-Parkinson-White Anomaly with bradycardia: Georgia ACP meeting; Lake Lanier, Georgia, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman Jr NS, Kintziger K, Kheda M, Sorrentino RA. (November 2013). Evaluation of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Oral Presentation presented at: Georgia ACC fellows presentation; Lake Oconee, Georgia USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
==Oral Presentations==&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Gao X, Haddad D, Liu E, Dunleavy M, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Acute Coronary Syndrome and Concurrent Amyloidosis. (2017 October) Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A. Sinoatrial node: Bench to bedside: OSU Cardiology Grand Rounds, Columbus, Ohio, USA. (2016 February) Unpublished&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman Jr NS, Kintziger K, Kheda M, Sorrentino RA. Evaluation of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. (May 2013). &#039;&#039;&#039;Oral Presentation presented at: Heart Rhythm Society. Late Breaking Clinical Tria&#039;&#039;&#039;l; Denver, Colorado USA. Published&lt;br /&gt;
&lt;br /&gt;
2008: Guha A, Vaidya V, Shah M, Sanghai S, Shukla E, Parikh R, Gala P, Shingada A, Goray A, Mansukhani S, Shah V. (2008, March). &#039;&#039;&#039;Phantom limb and the role of Virtual Mirror Box.&#039;&#039;&#039; Oral Presentation presented at: &#039;&#039;Bombay Medical Congress; Mumbai&#039;&#039;, India.&lt;br /&gt;
&lt;br /&gt;
2007: Guha A, Agarwal A, Sawant A, Surekha S, Krishnamoorty S et al. (2007, March). &#039;&#039;&#039;Paediatric HIV.&#039;&#039;&#039; Oral Presentation presented at: &#039;&#039;Bombay Medical Congress&#039;&#039;; Mumbai, India.&lt;br /&gt;
&lt;br /&gt;
==Editorial Boards==&lt;br /&gt;
&lt;br /&gt;
Associate Editor in Chief for [[Ventricular Tachycardia]] Section of wikidoc&lt;br /&gt;
&lt;br /&gt;
==Internet Educational Sites==&lt;br /&gt;
&lt;br /&gt;
Sharing information about boards and good literature is my passion http://www.avirupguha.co.nr&lt;br /&gt;
&lt;br /&gt;
[[Category:Medical Graduate]]&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=User:Avirupguha&amp;diff=1464113</id>
		<title>User:Avirupguha</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=User:Avirupguha&amp;diff=1464113"/>
		<updated>2018-04-19T13:06:11Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;&#039;&#039;&#039;Avirup Guha, M.B.B.S.&#039;&#039;&#039;, Associate Editor-in-Chief of [[Ventricular Tachycardia]], WikiDoc Foundation&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Contact:&#039;&#039;&#039; mailto:avirup.guha@gmail.com; &lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Download This Brief Bio as a PDF:&#039;&#039;&#039; [[media:Guha.pdf|CV]]&lt;br /&gt;
&lt;br /&gt;
__NOTOC__&lt;br /&gt;
----&lt;br /&gt;
Hi everyone coming to my page. I am Avirup Guha, a medical student from Seth G.S. Medical College, Mumbai, India batch of 2005. I have been trying to keep up the good work at all places-college and from home.&lt;br /&gt;
My subjects of interest – Cardiology, Gastroenterology and Radiology.&lt;br /&gt;
&lt;br /&gt;
==Education==&lt;br /&gt;
&lt;br /&gt;
I finished my training from Seth G.S. Medical College, Mumbai, India. I passed out with M.B.B.S. degree in May 2011. I did around 8 months of rotations in various US institutions in varied environments for US clinical experience.&lt;br /&gt;
&lt;br /&gt;
==Research==&lt;br /&gt;
&lt;br /&gt;
2009: June—November Seth G.S. Medical college, Mumbai,( Dr. Shobna Bhatia, Head of the Department: Department of Gastroenterology) &#039;&#039;&#039;&amp;quot;Quality of nutrition, especially medium chain fatty acids, in patients of alcoholic liver disease as compared to alcoholics without liver disease&amp;quot;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2008: January—2009: October Seth G.S. Medical college, Mumbai,( Dr. Prafulla Kerkar, Head of the Department: Department of Cardiology) &#039;&#039;&#039;“To study the clinical profile and predictors of recurrence in patients with Stable Ventricular Tachycardia”&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2006: September—2007: March Seth G.S. Medical college, Mumbai,( Dr. Nirmala Rege, Professor: Pharmacology) &#039;&#039;&#039;“Immunostimulatory Potential of Indian Medicinal Plants on Thymocytes of Swiss Albino Mice”&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
==Research Allowance==&lt;br /&gt;
&lt;br /&gt;
2009: Indian Council of Medical Research, Short Term Studentship (Pharmacology)&lt;br /&gt;
&lt;br /&gt;
==Publications==&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Full Publications&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2018: Foraker R, Guha A, Chang H, O’Brien E, Bower J, Crouser E, Rosamond W, Raman SV. Survival after MI in a Community Cohort Study: Contribution of Comorbidities in NSTEMI. Glob Heart. 2018 Feb 3. pii: S2211-8160(18)30002-4. (PMID: 29409724)&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Snider MJ, Boyd M, Afzal M, Badin A, Godara H, Liu Z, Tyler J, Weiss R, Kalbfleisch S, Augostini R, Hummel J, Houmsse M, Daoud EG. Initiation and Outcomes with Class Ic Antiarrhythmic Drug Therapy. Indian Pacing Electrophysiol J. 2017 Dec 7. pii: S0972-6292(17)30192-4. doi: 10.1016/j.ipej.2017.12.001. [Epub ahead of print] (PMID: 29225010)&lt;br /&gt;
&lt;br /&gt;
2017: Liu E, Guha A, Jia K, Ayers AM, Boudoulas KD, Bertino E, Franco V. Cardiogenic shock in a patient being treated with Atezolizumab for metastatic non-small cell lung cancer. Lung Cancer. 2017 Jul 29. pii: S0169-5002(17)30416-6. doi: 10.1016/j.lungcan.2017.07.028. [Epub ahead of print] (PMID: 28780994, 29292070)&lt;br /&gt;
&lt;br /&gt;
2017: Wiczer TE, Levine LB, Brumbaugh J, Coggins J, Zhao Q, Ruppert AS, Rogers K, McCoy A, Mousa L, Guha A, Maddocks K, Christian B, Andritsos LA, Jaglowski S, Devine S, Baiocchi R, Woyach J, Jones J, Grever M, Blum KA, Byrd JC, Awan FT: Incidence, Risk Factors, and Management of Atrial Fibrillation in Patients Receiving Ibrutinib for Hematologic Malignancies. Blood Adv. 2017 1:1739-1748; doi: 10.1182/bloodadvances.2017009720 (PMID: 29296820)&lt;br /&gt;
&lt;br /&gt;
2017: Dunleavy M, Guha A, Ernst K, Sullivan M, Voelkel AJ, Raman SV, Baker C, Dean S. Running without a vein: Congenital Absence of the Right Common Iliac Vein. Int J Cardiovasc Imaging. 2017. Accepted for publication.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Gao X, Dunleavy M, Liu E, Patel D, Fedorov VV, Daoud EG. Eleven-year trends of inpatient pacemaker implantation in patients diagnosed with sick sinus syndrome. J Cardiovasc Electrophysiol. 2017 May 4. doi: 10.1111/jce.13248. [Epub ahead of print] (PMID: 28471545)&lt;br /&gt;
&lt;br /&gt;
2016: Li N, Csepe TA, Hansen BJ, Sul LV, Kalyanasundaram A, Zakharkin SO, Zhao J, Guha A, Van Wagoner DR, Kilic A, Mohler PJ, Janssen PM, Biesiadecki BJ, Hummel JD, Weiss R, Fedorov VV: Adenosine-Induced Atrial Fibrillation: Localized Reentrant Drivers in Lateral Right Atria due to Heterogeneous Expression of Adenosine A1 Receptors and GIRK4 Subunits in the Human Heart. Circulation. 2016 Aug 9;134 (6):486-98. (PMID: 27462069)&lt;br /&gt;
&lt;br /&gt;
2016: O&#039;Connor PM, Guha A, Stilphen CA, Sun J, Jin C: Proton channels and renal hypertensive injury: a key piece of the Dahl salt-sensitive rat puzzle? Am J Physiol Regul Integr Comp Physiol. 2016 Feb 3:ajpregu.00115.2015. (PMID: 26843580)&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Merchen LA: Cerebral Cryptococcoma – but Why? J Kuwait Med Assoc. 2015 November. 47(4):346-347.&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Maddox WR, Colombo R, Nahman NS Jr, Kintziger KW, Waller JL, Diamond M, Murphy M, Kheda M, Litwin SE, Sorrentino RA. Evaluation Of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Heart Rhythm. 2015 Aug 4. pii: S1547-5271(15)01017-6. (PMID: 26253036)&lt;br /&gt;
&lt;br /&gt;
2015: Ayoola R, Guha A, Daram SR: Gastrointestinal Bleeding as the Initial Presentation of HIV/AIDS. Gastrointest Endosc. 2015 Apr 25. pii: S0016-5107(15)02117-3. (PMID: 25922245)&lt;br /&gt;
&lt;br /&gt;
2014: Jin C, Sun J, Stilphen CA, Smith SME, Ocasio H, Bermingham B, Darji S, Guha A, Patel R, Geurts AM, Jacob HJ, Lambert NA, O’Connor PM: HV1 ACTS AS A sodium SENSOR AND promotes superoxide production in medullary thick ascending limb of Dahl SALT-SENSITIVE rats. Hypertension. 2014 Sep; 64(3):541-50. (PMID: 24935944)&lt;br /&gt;
&lt;br /&gt;
2014: Murphy M, Krothapalli S, Cuellar J, Kanjanauthai S, Heeke B, Sharma P, Guha A, Barnes VA, Litwin S, Sharma G: Prognostic Value of Normal Stress Echocardiography in Obese Patients. J Obes. 2014 Aug; 2014:419724. (PMID: 25258682)&lt;br /&gt;
&lt;br /&gt;
2014: Guha A, Kulkarni HS: ATS Patient Series: What is Histoplasmosis? Am J of Resir Crit Care Med. 2012 Apr; 185:1–2.&lt;br /&gt;
&lt;br /&gt;
2012: Madhwal S, Goldberg J, Barcena J, Guha A, Gogate P, Cmolik B, Elgudin Y: An Unusual Cause of Acute Mitral Regurgitation: Idiopathic Hypereosinophilic Syndrome. Ann Tho Surg. 2012 Mar; 93(3):974-7. (PMID: 22364989).&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Published Abstracts&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Dunleavy M, Raman SV, Harfi TT. Left Atrial Appendage Enhancement Pattern on CT Pulmonary Venograms is Associated with Left Atrial Appendage Emptying Velocity as Measured by Doppler signal During Transesophageal Echocardiography. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Dunleavy M, Raman SV, Harfi TT. Cardiology Fellows Learning Curve and Inter-observer Variability in the Interpretation of the Left Atrial Appendage on Cardiac CT Pulmonary Venograms. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Dunleavy M, Raman SV, Harfi TT. Accuracy of Non-ECG Gated, Single Phase, Contrast-Enhanced Cardiac CT Pulmonary Venography in Left Atrial Appendage Thrombus Rule Out as compared to Transesophageal Echocardiogram. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Dunleavy M, Guha A, Raman SV, Harfi TT. Coronary Artery Calcification as Detected on Pre-Atrial Fibrillation Computed Tomography(CT) Pulmonary Venogram Helps Optimize Patient Selection for Statin Therapy in Patients with Atrial Fibrillation. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Liu E, Guha A, Dunleavy M, Obarski T. Is Upper Endoscopy Required in Cirrhotic Patients prior to TEE? Accepted for poster at American Society of Echocardiography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Buck B, Guha A, Arora S, Awan FT, Lopez-Mattei JC, Plana-Gomez JC, Oliviera G, Fradley M, Addison D. Survival of in-hospital cardiac arrest among cancer patients. Submitted to European Society of Cardiology 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Addison D, Derbala M, Wiczer TE, Byrd JC, Awan FT. Ventricular Arrhythmias in Patients Managed With Ibrutinib For Cancer Immunotherapy. Accepted for poster ACC 2018. J Am Coll Cardiol. March 2018; 71(11_S): doi: 10.1016/S0735-1097(18)30820-9&lt;br /&gt;
&lt;br /&gt;
2018: Briston D, Guha A, Zubizarreta N, Daniels C, Bradley E. Results From the WISH-ACHD Study: Women&#039;s Initiative in the Study of Hospitalizations in Adult Congenital Heart Disease. Accepted for oral presentation ACC 2018. March 2018; 71(11_S):10.1016/S0735-1097(18)31070-2&lt;br /&gt;
&lt;br /&gt;
2017: Okabe T, Buck B, Guha A, Gao X, Liu E, Dunleavy M, Haddad D, Daoud EG. Short- And Mid-term Hospitalization for Recurrence Of Atrial Fibrillation After Catheter Ablation In Obese Patients. Accepted for oral presentation at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A16417.&lt;br /&gt;
&lt;br /&gt;
2017: Buck B, Guha A, Gao X, Liu E, Dunleavy M, Haddad D, Daoud EG, Okabe T. CHA2DS2-Vasc Score Predicts 30-day Thromboembolic Risk after Cardioversion of Atrial Fibrillation. Accepted for poster at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A18484.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Dunleavy M, Asad SY, Gao X, Liu E, Haddad D, Baliga R, Awan F, Mehta L. 12 Year Trends In Out Of Hospital Cardiac Arrest In Patients With Cancer. Accepted for poster at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A15968.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Yuan Z, Gao X, Liu E, Dunleavy M, Derbala M, Efebera Y, Baliga R, Smith S. National Trends in Hospitalization of Patients with Diastolic Heart Failure and Concurrent Amyloidosis. Accepted for poster at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A11678.&lt;br /&gt;
&lt;br /&gt;
2017: Buck B, Guha A, Gao X, Haddad D, Liu E, Dunleavy M, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Acute Coronary Syndrome and Concurrent Amyloidosis. Accepted for poster at the European Heart Congress meeting 2017. Eur Heart J. 2017; 38 (S1): ehx504.P4690.&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Houmsse M, Snider M, Daoud EG. Exercise Testing in Patients Treated with Class IC Antiarrhythmic Drug. Accepted for poster at HRS 2017 meeting. Heart Rhythm. 2017; 14 (5S): S514–S563&lt;br /&gt;
&lt;br /&gt;
2017: Buck B, Guha A, Gao X, Awan F, Hofmeister C, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Atrial Fibrillation and Concurrent Amyloidosis. Accepted for poster at HRS 2017 meeting. Heart Rhythm. 2017; 14 (5S): S144–S234&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Xiang X, Patel D, Fedorov VV, Daoud EG: 11 year Trends and Utilization Patterns of Cardiac Implantable Electronic Devices in Patients Diagnosed With Sick Sinus Syndrome. Accepted for poster AHA 2016. Circulation. 2016;134: A12756.&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Bower JK, Foraker R, Smith S: Ventricular Tachycardia and Sick Sinus Syndrome in Neoplasia. Accepted for poster Heart Rhythm 2016. Heart Rhythm. 2016; 13 (5S): S340–S426&lt;br /&gt;
&lt;br /&gt;
2015: Murphy M, Guha A, Maddox WR, Waller J, Sorrentino RA, Diamond M, Nahman, NS Jr: Modified HASBLED bleeding risk score in dialysis patients with atrial fibrillation. Accepted for poster AHA 2015. Circulation. 2015; 132: A12014&lt;br /&gt;
&lt;br /&gt;
2014: Patel NJ, Deshmukh AJ, Guha A, Mitrani RD, Paydak H, Viles-Gonzales J, Kowalski M et al: Gender, Racial and Insurance disparities in the Cardiac Resynchronization Therapy: Trends over the last decade. Circulation. Accepted for poster AHA 2014. Circulation. 2014; 130:A206.&lt;br /&gt;
&lt;br /&gt;
2014: Deshmukh A, Deshmukh AJ, Guha A, Desimone CV, Joshi M et al: Utilization and Outcome of Therapeutic Hypothermia for Out of Hospital Cardiac Arrest. Accepted for poster AHA 2014. Circulation. 2014; 130:A19401.&lt;br /&gt;
&lt;br /&gt;
2014: Deshmukh A, Patel NJ, Deshmukh AJ, Guha A, Desimone CV, Joshi M et al: Seasonal Variation of Out of Hospital Cardiac Arrest. Accepted for poster AHA 2014. Circulation. 2014; 130:A51.&lt;br /&gt;
&lt;br /&gt;
2014: Maddox WR, Waller J, Guha A, J Cuellar J, Diamond M, Murphy M, Litwin S, Nahman NS Jr, Kheda M, Sorrentino R: A Dialysis-Specific Risk Stratification Score Improves Stroke Prediction in Dialysis Patients with Atrial Fibrillation. Accepted for poster AHA 2014. Circulation. 2014; 130:A17629.&lt;br /&gt;
&lt;br /&gt;
2014: Diamond M, Maddox WR, Waller J, Guha A, J Cuellar J, Murphy M, Litwin S, Kheda M, Sorrentino R, Nahman NS Jr: Risk Factors of Stroke or Mortality in and after 90 days of Atrial Fibrillation Diagnosis in Dialysis Patients. Accepted for poster ASN 2014. J Am Soc Nephrol. 2014; 25: FR-PO1029.&lt;br /&gt;
&lt;br /&gt;
2014: J Cuellar J, Waller J, Guha A, Diamond M, Sorrentino R, Murphy M, Litwin S, Nahman NS Jr, Kheda M, Maddox M: CHA2DS2VASc score predicts stroke in dialysis patients with atrial fibrillation. Accepted for oral presentation ACC 2014. J Am Coll Cardiol. 2014; 63(12_S): doi: 10.1016/S0735-1097(14)60297-7.&lt;br /&gt;
&lt;br /&gt;
2014: Murphy M, J Cuellar J, Waller J, Guha A, Diamond M, Sorrentino R, Litwin S, Nahman NS Jr, Kheda M, Maddox M: CHA2DS2VASc score predicts mortality in dialysis patients with atrial fibrillation. Accepted for poster ACC 2014. J Am Coll Cardiol. 2014; 63(12_S): doi: 10.1016/S0735-1097(14)60358-2.&lt;br /&gt;
&lt;br /&gt;
2014: Guha A, Sun J, O’Connor PM: Apical NH4Cl acts to reduce intracellular Na concentration in mTAL via cellular depolarization. Accepted for poster Experimental Biology 2014. FASEB J. April 2014 28:1098.6.&lt;br /&gt;
&lt;br /&gt;
2014: Maddox WR, Kintziger K, Colombo R, Guha A, Kheda M, Nahman NS Jr, Sorrentino R: Mortality Following Cardiac Implantable Electronic Device Infection in Dialysis Patients from the USRDS. Accepted for oral presentation Heart Rhythm 2014. Heart Rhythm. 2014; 11 (S5): AB28-03.&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Sorrentino RA, Ghaffari A, Colombo R, Ellington CL, Chebrolu P, Kheda M, Nahman Jr NS, Kintziger K : Non-traditional risk factors for myocardial infarction and systolic heart failure following kidney transplantation. Accepted for poster ESC 2013. Eur Heart J. 2013; 34 (S1): 312.&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Sorrentino RA, Colombo R, Kheda M, Nahman Jr NS, Kintziger K. Evaluation Of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Late breaking clinical trials/oral plenary presentation of Heart Rhythm. Heart Rhythm, May 2013; published online.&lt;br /&gt;
&lt;br /&gt;
2013: Maddox W, Kintziger K, Colombo R, Guha A, Kheda M, Nahman S, Sorrentino R: Risk of cardiac implantable electronic device infection in hemodialysis or peritoneal dialysis: evaluation of a large end stage renal disease database. Accepted for poster AHA 2013. Circulation. 2013; 128: A16808.&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman NS Jr, Kintziger K, Merchen T, Kheda M, Sorrentino R: Non-traditional risk factors for atrial fibrillation following kidney transplantation. Accepted for poster AHA 2013. Circulation. 2013; 128:A12632.&lt;br /&gt;
&lt;br /&gt;
2013: Ghaffari A, Ellington CL, Colombo R, Baer S, Huber L, Guha A, Whitlow M, Chebrolu P, Nahman Jr NS, Kintziger K, Merchen T: Vasculopathic risk factors for delayed graft function in kidney transplantation. Accepted for poster at American Transplant Congress 2013. Amer J Transplant. 2013; 13 (S5):525.&lt;br /&gt;
&lt;br /&gt;
2012: Madhwal S, Guha A, Atreja A, Gupta P, Albeldawdi M, Post A, Costa A: Is Metabolic syndrome post Liver Transplantation a Risk Factor for Cardiovascular Disease? Accepted for poster AHA 2013. Circulation. 2012; 126: A18429.&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Poster/Online Presentations (published and unpublished)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Cardona A, Nagaraja HN, Raman SV, Zareba KM. Prognostic value of midwall fibrosis in patients with preserved ejection fraction and structurally normal heart (pilot study). Accepted for poster at CMR 2018, Barcelona, Spain. Published online - &amp;lt;nowiki&amp;gt;http://cmr2018.org/wp-content/uploads/2018/01/Abstract-Supplement-Book.pdf&amp;lt;/nowiki&amp;gt;&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Okabe T, Buck B, Gao X, Liu E, Dunleavy M, Haddad D, Daoud EG. Short- And Mid-term Hospitalization for Recurrence Of Atrial Fibrillation After Catheter Ablation In Obese Patients. (2017 November) American Association of Cardiologist of Indian Origin Annual Meeting, Anaheim, California, USA. Unpublished.&lt;br /&gt;
&lt;br /&gt;
2017: Franco DA, Gao X, Guha A, Buck B, Patel D, Snider MJ, Boyd M, Afzal M, Badin A, Godara H, Liu Z, Tyler J, Weiss R, Kalbfleisch S, Augostini R, Hummel J, Houmsse M, Daoud EG. Initiation and Outcomes with Class Ic Antiarrhythmic Drug Therapy. (2017 October) Ohio ACC meeting, Columbus, Ohio, USA. Unpublished.&lt;br /&gt;
&lt;br /&gt;
2017: Briston D, Guha A, Zubizarreta N, Daniels C, Bradley EA. Pregnancy in Congenital Heart Disease: Analysis of Maternal Cardiovascular Hospitalizations. (2017 September) Annual International Symposium on Adult Congenital Heart Disease, Cincinnati, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Dunleavy M, Guha A, Ernst K, Sullivan M, Voelkel AJ, Raman SV, Baker C, Dean S. Running without a vein: Congenital Absence of the Right Common Iliac Vein. (2017 June) NASCI Case in Point. Accepted for online publication.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Gao X, Dunleavy M, Liu E, Patel D, Fedorov VV, Daoud EG. Eleven year trends of inpatient pacemaker implantation in patients diagnosed with sick sinus syndrome. (2017 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Houmsse M, Snider M, Daoud EG. Exercise Testing in Patients Treated with Class IC Antiarrhythmic Drug. (2017 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Gao X, Awan F, Hofmeister C, Daoud EG, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Atrial Fibrillation and Concurrent Amyloidosis. (2017 April): OSUCCC – James Annual Scientific Meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Chang H, O’Brien E, Bower J, Crouser E, Rosamond W, Raman SV, Foraker R. Community-based mortality risk due to acute coronary syndromes: An ARIC study. (2016 October): Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Bower JK, Foraker R, Smith S. Ventricular Tachycardia and Sick Sinus Syndrome in Neoplasia. (2016 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Dooling PC, Ramsey ML, Guha A, Sofowora G. Connective Tissue Disease Presenting as Pericardial Effusion with Tamponade. (2016 May) OSU Internal Medicine Research day, Case Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Ruden E, Raman S. Unusual cardiac iron overload in a sickle cell disease patient. (2015 October): Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2014: Baker S, Guha A, Mitulescu L, Murphy M, Cuomo J, Haydour Q, Sorrentino RA. (October 2014). Slow Excitation: The remarkable presentation of Wolff-Parkinson-White Anomaly with bradycardia: Georgia ACP meeting; Lake Lanier, Georgia, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman Jr NS, Kintziger K, Kheda M, Sorrentino RA. (November 2013). Evaluation of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Oral Presentation presented at: Georgia ACC fellows presentation; Lake Oconee, Georgia USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
==Oral Presentations==&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Gao X, Haddad D, Liu E, Dunleavy M, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Acute Coronary Syndrome and Concurrent Amyloidosis. (2017 October) Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A. Sinoatrial node: Bench to bedside: OSU Cardiology Grand Rounds, Columbus, Ohio, USA. (2016 February) Unpublished&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman Jr NS, Kintziger K, Kheda M, Sorrentino RA. Evaluation of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. (May 2013). &#039;&#039;&#039;Oral Presentation presented at: Heart Rhythm Society. Late Breaking Clinical Tria&#039;&#039;&#039;l; Denver, Colorado USA. Published&lt;br /&gt;
&lt;br /&gt;
2008: Guha A, Vaidya V, Shah M, Sanghai S, Shukla E, Parikh R, Gala P, Shingada A, Goray A, Mansukhani S, Shah V. (2008, March). &#039;&#039;&#039;Phantom limb and the role of Virtual Mirror Box.&#039;&#039;&#039; Oral Presentation presented at: &#039;&#039;Bombay Medical Congress; Mumbai&#039;&#039;, India.&lt;br /&gt;
&lt;br /&gt;
2007: Guha A, Agarwal A, Sawant A, Surekha S, Krishnamoorty S et al. (2007, March). &#039;&#039;&#039;Paediatric HIV.&#039;&#039;&#039; Oral Presentation presented at: &#039;&#039;Bombay Medical Congress&#039;&#039;; Mumbai, India.&lt;br /&gt;
&lt;br /&gt;
==Editorial Boards==&lt;br /&gt;
&lt;br /&gt;
Associate Editor in Chief for [[Ventricular Tachycardia]] Section of wikidoc&lt;br /&gt;
&lt;br /&gt;
==Internet Educational Sites==&lt;br /&gt;
&lt;br /&gt;
Sharing information about boards and good literature is my passion http://www.avirupguha.co.nr&lt;br /&gt;
&lt;br /&gt;
[[Category:Medical Graduate]]&lt;/div&gt;</summary>
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		<updated>2018-04-19T12:53:41Z</updated>

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		<updated>2018-04-19T12:52:47Z</updated>

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		<updated>2018-04-19T12:52:37Z</updated>

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		<updated>2018-04-19T12:51:13Z</updated>

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		<updated>2018-04-19T12:49:49Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: /* Oral Presentations */&lt;/p&gt;
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&lt;div&gt;[[Image:guha.jpg|right|Avirup Guha, M.B.B.S.]]&lt;br /&gt;
&#039;&#039;&#039;Avirup Guha, M.B.B.S.&#039;&#039;&#039;, Associate Editor-in-Chief of [[Ventricular Tachycardia]], WikiDoc Foundation&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Contact:&#039;&#039;&#039; mailto:avirup.guha@gmail.com; &lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Download This Brief Bio as a PDF:&#039;&#039;&#039; [[media:Guha.pdf|CV]]&lt;br /&gt;
&lt;br /&gt;
__NOTOC__&lt;br /&gt;
----&lt;br /&gt;
Hi everyone coming to my page. I am Avirup Guha, a medical student from Seth G.S. Medical College, Mumbai, India batch of 2005. I have been trying to keep up the good work at all places-college and from home.&lt;br /&gt;
My subjects of interest – Cardiology, Gastroenterology and Radiology.&lt;br /&gt;
&lt;br /&gt;
==Education==&lt;br /&gt;
&lt;br /&gt;
I finished my training from Seth G.S. Medical College, Mumbai, India. I passed out with M.B.B.S. degree in May 2011. I did around 8 months of rotations in various US institutions in varied environments for US clinical experience.&lt;br /&gt;
&lt;br /&gt;
==Research==&lt;br /&gt;
&lt;br /&gt;
2009: June—November Seth G.S. Medical college, Mumbai,( Dr. Shobna Bhatia, Head of the Department: Department of Gastroenterology) &#039;&#039;&#039;&amp;quot;Quality of nutrition, especially medium chain fatty acids, in patients of alcoholic liver disease as compared to alcoholics without liver disease&amp;quot;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2008: January—2009: October Seth G.S. Medical college, Mumbai,( Dr. Prafulla Kerkar, Head of the Department: Department of Cardiology) &#039;&#039;&#039;“To study the clinical profile and predictors of recurrence in patients with Stable Ventricular Tachycardia”&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2006: September—2007: March Seth G.S. Medical college, Mumbai,( Dr. Nirmala Rege, Professor: Pharmacology) &#039;&#039;&#039;“Immunostimulatory Potential of Indian Medicinal Plants on Thymocytes of Swiss Albino Mice”&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
==Research Allowance==&lt;br /&gt;
&lt;br /&gt;
2009: Indian Council of Medical Research, Short Term Studentship (Pharmacology)&lt;br /&gt;
&lt;br /&gt;
==Publications==&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Full Publications&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2018: Foraker R, Guha A, Chang H, O’Brien E, Bower J, Crouser E, Rosamond W, Raman SV. Survival after MI in a Community Cohort Study: Contribution of Comorbidities in NSTEMI. Glob Heart. 2018 Feb 3. pii: S2211-8160(18)30002-4. (PMID: 29409724)&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Snider MJ, Boyd M, Afzal M, Badin A, Godara H, Liu Z, Tyler J, Weiss R, Kalbfleisch S, Augostini R, Hummel J, Houmsse M, Daoud EG. Initiation and Outcomes with Class Ic Antiarrhythmic Drug Therapy. Indian Pacing Electrophysiol J. 2017 Dec 7. pii: S0972-6292(17)30192-4. doi: 10.1016/j.ipej.2017.12.001. [Epub ahead of print] (PMID: 29225010)&lt;br /&gt;
&lt;br /&gt;
2017: Liu E, Guha A, Jia K, Ayers AM, Boudoulas KD, Bertino E, Franco V. Cardiogenic shock in a patient being treated with Atezolizumab for metastatic non-small cell lung cancer. Lung Cancer. 2017 Jul 29. pii: S0169-5002(17)30416-6. doi: 10.1016/j.lungcan.2017.07.028. [Epub ahead of print] (PMID: 28780994, 29292070)&lt;br /&gt;
&lt;br /&gt;
2017: Wiczer TE, Levine LB, Brumbaugh J, Coggins J, Zhao Q, Ruppert AS, Rogers K, McCoy A, Mousa L, Guha A, Maddocks K, Christian B, Andritsos LA, Jaglowski S, Devine S, Baiocchi R, Woyach J, Jones J, Grever M, Blum KA, Byrd JC, Awan FT: Incidence, Risk Factors, and Management of Atrial Fibrillation in Patients Receiving Ibrutinib for Hematologic Malignancies. Blood Adv. 2017 1:1739-1748; doi: 10.1182/bloodadvances.2017009720 (PMID: 29296820)&lt;br /&gt;
&lt;br /&gt;
2017: Dunleavy M, Guha A, Ernst K, Sullivan M, Voelkel AJ, Raman SV, Baker C, Dean S. Running without a vein: Congenital Absence of the Right Common Iliac Vein. Int J Cardiovasc Imaging. 2017. Accepted for publication.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Gao X, Dunleavy M, Liu E, Patel D, Fedorov VV, Daoud EG. Eleven-year trends of inpatient pacemaker implantation in patients diagnosed with sick sinus syndrome. J Cardiovasc Electrophysiol. 2017 May 4. doi: 10.1111/jce.13248. [Epub ahead of print] (PMID: 28471545)&lt;br /&gt;
&lt;br /&gt;
2016: Li N, Csepe TA, Hansen BJ, Sul LV, Kalyanasundaram A, Zakharkin SO, Zhao J, Guha A, Van Wagoner DR, Kilic A, Mohler PJ, Janssen PM, Biesiadecki BJ, Hummel JD, Weiss R, Fedorov VV: Adenosine-Induced Atrial Fibrillation: Localized Reentrant Drivers in Lateral Right Atria due to Heterogeneous Expression of Adenosine A1 Receptors and GIRK4 Subunits in the Human Heart. Circulation. 2016 Aug 9;134 (6):486-98. (PMID: 27462069)&lt;br /&gt;
&lt;br /&gt;
2016: O&#039;Connor PM, Guha A, Stilphen CA, Sun J, Jin C: Proton channels and renal hypertensive injury: a key piece of the Dahl salt-sensitive rat puzzle? Am J Physiol Regul Integr Comp Physiol. 2016 Feb 3:ajpregu.00115.2015. (PMID: 26843580)&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Merchen LA: Cerebral Cryptococcoma – but Why? J Kuwait Med Assoc. 2015 November. 47(4):346-347.&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Maddox WR, Colombo R, Nahman NS Jr, Kintziger KW, Waller JL, Diamond M, Murphy M, Kheda M, Litwin SE, Sorrentino RA. Evaluation Of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Heart Rhythm. 2015 Aug 4. pii: S1547-5271(15)01017-6. (PMID: 26253036)&lt;br /&gt;
&lt;br /&gt;
2015: Ayoola R, Guha A, Daram SR: Gastrointestinal Bleeding as the Initial Presentation of HIV/AIDS. Gastrointest Endosc. 2015 Apr 25. pii: S0016-5107(15)02117-3. (PMID: 25922245)&lt;br /&gt;
&lt;br /&gt;
2014: Jin C, Sun J, Stilphen CA, Smith SME, Ocasio H, Bermingham B, Darji S, Guha A, Patel R, Geurts AM, Jacob HJ, Lambert NA, O’Connor PM: HV1 ACTS AS A sodium SENSOR AND promotes superoxide production in medullary thick ascending limb of Dahl SALT-SENSITIVE rats. Hypertension. 2014 Sep; 64(3):541-50. (PMID: 24935944)&lt;br /&gt;
&lt;br /&gt;
2014: Murphy M, Krothapalli S, Cuellar J, Kanjanauthai S, Heeke B, Sharma P, Guha A, Barnes VA, Litwin S, Sharma G: Prognostic Value of Normal Stress Echocardiography in Obese Patients. J Obes. 2014 Aug; 2014:419724. (PMID: 25258682)&lt;br /&gt;
&lt;br /&gt;
2014: Guha A, Kulkarni HS: ATS Patient Series: What is Histoplasmosis? Am J of Resir Crit Care Med. 2012 Apr; 185:1–2.&lt;br /&gt;
&lt;br /&gt;
2012: Madhwal S, Goldberg J, Barcena J, Guha A, Gogate P, Cmolik B, Elgudin Y: An Unusual Cause of Acute Mitral Regurgitation: Idiopathic Hypereosinophilic Syndrome. Ann Tho Surg. 2012 Mar; 93(3):974-7. (PMID: 22364989).&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Published Abstracts&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Dunleavy M, Raman SV, Harfi TT. Left Atrial Appendage Enhancement Pattern on CT Pulmonary Venograms is Associated with Left Atrial Appendage Emptying Velocity as Measured by Doppler signal During Transesophageal Echocardiography. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Dunleavy M, Raman SV, Harfi TT. Cardiology Fellows Learning Curve and Inter-observer Variability in the Interpretation of the Left Atrial Appendage on Cardiac CT Pulmonary Venograms. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Dunleavy M, Raman SV, Harfi TT. Accuracy of Non-ECG Gated, Single Phase, Contrast-Enhanced Cardiac CT Pulmonary Venography in Left Atrial Appendage Thrombus Rule Out as compared to Transesophageal Echocardiogram. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Dunleavy M, Guha A, Raman SV, Harfi TT. Coronary Artery Calcification as Detected on Pre-Atrial Fibrillation Computed Tomography(CT) Pulmonary Venogram Helps Optimize Patient Selection for Statin Therapy in Patients with Atrial Fibrillation. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting. Submitted to Society of Cardiovascular Computed Tomography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Liu E, Guha A, Dunleavy M, Obarski T. Is Upper Endoscopy Required in Cirrhotic Patients prior to TEE? Accepted for poster at American Society of Echocardiography 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Buck B, Guha A, Arora S, Awan FT, Lopez-Mattei JC, Plana-Gomez JC, Oliviera G, Fradley M, Addison D. Survival of in-hospital cardiac arrest among cancer patients. Submitted to European Society of Cardiology 2018 meeting.&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Addison D, Derbala M, Wiczer TE, Byrd JC, Awan FT. Ventricular Arrhythmias in Patients Managed With Ibrutinib For Cancer Immunotherapy. Accepted for poster ACC 2018. J Am Coll Cardiol. March 2018; 71(11_S): doi: 10.1016/S0735-1097(18)30820-9&lt;br /&gt;
&lt;br /&gt;
2018: Briston D, Guha A, Zubizarreta N, Daniels C, Bradley E. Results From the WISH-ACHD Study: Women&#039;s Initiative in the Study of Hospitalizations in Adult Congenital Heart Disease. Accepted for oral presentation ACC 2018. March 2018; 71(11_S):10.1016/S0735-1097(18)31070-2&lt;br /&gt;
&lt;br /&gt;
2017: Okabe T, Buck B, Guha A, Gao X, Liu E, Dunleavy M, Haddad D, Daoud EG. Short- And Mid-term Hospitalization for Recurrence Of Atrial Fibrillation After Catheter Ablation In Obese Patients. Accepted for oral presentation at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A16417.&lt;br /&gt;
&lt;br /&gt;
2017: Buck B, Guha A, Gao X, Liu E, Dunleavy M, Haddad D, Daoud EG, Okabe T. CHA2DS2-Vasc Score Predicts 30-day Thromboembolic Risk after Cardioversion of Atrial Fibrillation. Accepted for poster at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A18484.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Dunleavy M, Asad SY, Gao X, Liu E, Haddad D, Baliga R, Awan F, Mehta L. 12 Year Trends In Out Of Hospital Cardiac Arrest In Patients With Cancer. Accepted for poster at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A15968.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Yuan Z, Gao X, Liu E, Dunleavy M, Derbala M, Efebera Y, Baliga R, Smith S. National Trends in Hospitalization of Patients with Diastolic Heart Failure and Concurrent Amyloidosis. Accepted for poster at the American Heart Association Scientific Sessions 2017. Circulation. 2017; 136:A11678.&lt;br /&gt;
&lt;br /&gt;
2017: Buck B, Guha A, Gao X, Haddad D, Liu E, Dunleavy M, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Acute Coronary Syndrome and Concurrent Amyloidosis. Accepted for poster at the European Heart Congress meeting 2017. Eur Heart J. 2017; 38 (S1): ehx504.P4690.&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Houmsse M, Snider M, Daoud EG. Exercise Testing in Patients Treated with Class IC Antiarrhythmic Drug. Accepted for poster at HRS 2017 meeting. Heart Rhythm. 2017; 14 (5S): S514–S563&lt;br /&gt;
&lt;br /&gt;
2017: Buck B, Guha A, Gao X, Awan F, Hofmeister C, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Atrial Fibrillation and Concurrent Amyloidosis. Accepted for poster at HRS 2017 meeting. Heart Rhythm. 2017; 14 (5S): S144–S234&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Xiang X, Patel D, Fedorov VV, Daoud EG: 11 year Trends and Utilization Patterns of Cardiac Implantable Electronic Devices in Patients Diagnosed With Sick Sinus Syndrome. Accepted for poster AHA 2016. Circulation. 2016;134: A12756.&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Bower JK, Foraker R, Smith S: Ventricular Tachycardia and Sick Sinus Syndrome in Neoplasia. Accepted for poster Heart Rhythm 2016. Heart Rhythm. 2016; 13 (5S): S340–S426&lt;br /&gt;
&lt;br /&gt;
2015: Murphy M, Guha A, Maddox WR, Waller J, Sorrentino RA, Diamond M, Nahman, NS Jr: Modified HASBLED bleeding risk score in dialysis patients with atrial fibrillation. Accepted for poster AHA 2015. Circulation. 2015; 132: A12014&lt;br /&gt;
&lt;br /&gt;
2014: Patel NJ, Deshmukh AJ, Guha A, Mitrani RD, Paydak H, Viles-Gonzales J, Kowalski M et al: Gender, Racial and Insurance disparities in the Cardiac Resynchronization Therapy: Trends over the last decade. Circulation. Accepted for poster AHA 2014. Circulation. 2014; 130:A206.&lt;br /&gt;
&lt;br /&gt;
2014: Deshmukh A, Deshmukh AJ, Guha A, Desimone CV, Joshi M et al: Utilization and Outcome of Therapeutic Hypothermia for Out of Hospital Cardiac Arrest. Accepted for poster AHA 2014. Circulation. 2014; 130:A19401.&lt;br /&gt;
&lt;br /&gt;
2014: Deshmukh A, Patel NJ, Deshmukh AJ, Guha A, Desimone CV, Joshi M et al: Seasonal Variation of Out of Hospital Cardiac Arrest. Accepted for poster AHA 2014. Circulation. 2014; 130:A51.&lt;br /&gt;
&lt;br /&gt;
2014: Maddox WR, Waller J, Guha A, J Cuellar J, Diamond M, Murphy M, Litwin S, Nahman NS Jr, Kheda M, Sorrentino R: A Dialysis-Specific Risk Stratification Score Improves Stroke Prediction in Dialysis Patients with Atrial Fibrillation. Accepted for poster AHA 2014. Circulation. 2014; 130:A17629.&lt;br /&gt;
&lt;br /&gt;
2014: Diamond M, Maddox WR, Waller J, Guha A, J Cuellar J, Murphy M, Litwin S, Kheda M, Sorrentino R, Nahman NS Jr: Risk Factors of Stroke or Mortality in and after 90 days of Atrial Fibrillation Diagnosis in Dialysis Patients. Accepted for poster ASN 2014. J Am Soc Nephrol. 2014; 25: FR-PO1029.&lt;br /&gt;
&lt;br /&gt;
2014: J Cuellar J, Waller J, Guha A, Diamond M, Sorrentino R, Murphy M, Litwin S, Nahman NS Jr, Kheda M, Maddox M: CHA2DS2VASc score predicts stroke in dialysis patients with atrial fibrillation. Accepted for oral presentation ACC 2014. J Am Coll Cardiol. 2014; 63(12_S): doi: 10.1016/S0735-1097(14)60297-7.&lt;br /&gt;
&lt;br /&gt;
2014: Murphy M, J Cuellar J, Waller J, Guha A, Diamond M, Sorrentino R, Litwin S, Nahman NS Jr, Kheda M, Maddox M: CHA2DS2VASc score predicts mortality in dialysis patients with atrial fibrillation. Accepted for poster ACC 2014. J Am Coll Cardiol. 2014; 63(12_S): doi: 10.1016/S0735-1097(14)60358-2.&lt;br /&gt;
&lt;br /&gt;
2014: Guha A, Sun J, O’Connor PM: Apical NH4Cl acts to reduce intracellular Na concentration in mTAL via cellular depolarization. Accepted for poster Experimental Biology 2014. FASEB J. April 2014 28:1098.6.&lt;br /&gt;
&lt;br /&gt;
2014: Maddox WR, Kintziger K, Colombo R, Guha A, Kheda M, Nahman NS Jr, Sorrentino R: Mortality Following Cardiac Implantable Electronic Device Infection in Dialysis Patients from the USRDS. Accepted for oral presentation Heart Rhythm 2014. Heart Rhythm. 2014; 11 (S5): AB28-03.&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Sorrentino RA, Ghaffari A, Colombo R, Ellington CL, Chebrolu P, Kheda M, Nahman Jr NS, Kintziger K : Non-traditional risk factors for myocardial infarction and systolic heart failure following kidney transplantation. Accepted for poster ESC 2013. Eur Heart J. 2013; 34 (S1): 312.&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Sorrentino RA, Colombo R, Kheda M, Nahman Jr NS, Kintziger K. Evaluation Of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Late breaking clinical trials/oral plenary presentation of Heart Rhythm. Heart Rhythm, May 2013; published online.&lt;br /&gt;
&lt;br /&gt;
2013: Maddox W, Kintziger K, Colombo R, Guha A, Kheda M, Nahman S, Sorrentino R: Risk of cardiac implantable electronic device infection in hemodialysis or peritoneal dialysis: evaluation of a large end stage renal disease database. Accepted for poster AHA 2013. Circulation. 2013; 128: A16808.&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman NS Jr, Kintziger K, Merchen T, Kheda M, Sorrentino R: Non-traditional risk factors for atrial fibrillation following kidney transplantation. Accepted for poster AHA 2013. Circulation. 2013; 128:A12632.&lt;br /&gt;
&lt;br /&gt;
2013: Ghaffari A, Ellington CL, Colombo R, Baer S, Huber L, Guha A, Whitlow M, Chebrolu P, Nahman Jr NS, Kintziger K, Merchen T: Vasculopathic risk factors for delayed graft function in kidney transplantation. Accepted for poster at American Transplant Congress 2013. Amer J Transplant. 2013; 13 (S5):525.&lt;br /&gt;
&lt;br /&gt;
2012: Madhwal S, Guha A, Atreja A, Gupta P, Albeldawdi M, Post A, Costa A: Is Metabolic syndrome post Liver Transplantation a Risk Factor for Cardiovascular Disease? Accepted for poster AHA 2013. Circulation. 2012; 126: A18429.&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Poster/Online Presentations (published and unpublished)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Cardona A, Nagaraja HN, Raman SV, Zareba KM. Prognostic value of midwall fibrosis in patients with preserved ejection fraction and structurally normal heart (pilot study). Accepted for poster at CMR 2018, Barcelona, Spain. Published online - &amp;lt;nowiki&amp;gt;http://cmr2018.org/wp-content/uploads/2018/01/Abstract-Supplement-Book.pdf&amp;lt;/nowiki&amp;gt;&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Okabe T, Buck B, Gao X, Liu E, Dunleavy M, Haddad D, Daoud EG. Short- And Mid-term Hospitalization for Recurrence Of Atrial Fibrillation After Catheter Ablation In Obese Patients. (2017 November) American Association of Cardiologist of Indian Origin Annual Meeting, Anaheim, California, USA. Unpublished.&lt;br /&gt;
&lt;br /&gt;
2017: Franco DA, Gao X, Guha A, Buck B, Patel D, Snider MJ, Boyd M, Afzal M, Badin A, Godara H, Liu Z, Tyler J, Weiss R, Kalbfleisch S, Augostini R, Hummel J, Houmsse M, Daoud EG. Initiation and Outcomes with Class Ic Antiarrhythmic Drug Therapy. (2017 October) Ohio ACC meeting, Columbus, Ohio, USA. Unpublished.&lt;br /&gt;
&lt;br /&gt;
2017: Briston D, Guha A, Zubizarreta N, Daniels C, Bradley EA. Pregnancy in Congenital Heart Disease: Analysis of Maternal Cardiovascular Hospitalizations. (2017 September) Annual International Symposium on Adult Congenital Heart Disease, Cincinnati, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Dunleavy M, Guha A, Ernst K, Sullivan M, Voelkel AJ, Raman SV, Baker C, Dean S. Running without a vein: Congenital Absence of the Right Common Iliac Vein. (2017 June) NASCI Case in Point. Accepted for online publication.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Gao X, Dunleavy M, Liu E, Patel D, Fedorov VV, Daoud EG. Eleven year trends of inpatient pacemaker implantation in patients diagnosed with sick sinus syndrome. (2017 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Houmsse M, Snider M, Daoud EG. Exercise Testing in Patients Treated with Class IC Antiarrhythmic Drug. (2017 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Gao X, Awan F, Hofmeister C, Daoud EG, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Atrial Fibrillation and Concurrent Amyloidosis. (2017 April): OSUCCC – James Annual Scientific Meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Chang H, O’Brien E, Bower J, Crouser E, Rosamond W, Raman SV, Foraker R. Community-based mortality risk due to acute coronary syndromes: An ARIC study. (2016 October): Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Bower JK, Foraker R, Smith S. Ventricular Tachycardia and Sick Sinus Syndrome in Neoplasia. (2016 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Dooling PC, Ramsey ML, Guha A, Sofowora G. Connective Tissue Disease Presenting as Pericardial Effusion with Tamponade. (2016 May) OSU Internal Medicine Research day, Case Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Ruden E, Raman S. Unusual cardiac iron overload in a sickle cell disease patient. (2015 October): Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2014: Baker S, Guha A, Mitulescu L, Murphy M, Cuomo J, Haydour Q, Sorrentino RA. (October 2014). Slow Excitation: The remarkable presentation of Wolff-Parkinson-White Anomaly with bradycardia: Georgia ACP meeting; Lake Lanier, Georgia, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman Jr NS, Kintziger K, Kheda M, Sorrentino RA. (November 2013). Evaluation of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Oral Presentation presented at: Georgia ACC fellows presentation; Lake Oconee, Georgia USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
==Oral Presentations==&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Gao X, Haddad D, Liu E, Dunleavy M, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Acute Coronary Syndrome and Concurrent Amyloidosis. (2017 October) Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A. Sinoatrial node: Bench to bedside: OSU Cardiology Grand Rounds, Columbus, Ohio, USA. (2016 February) Unpublished&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman Jr NS, Kintziger K, Kheda M, Sorrentino RA. Evaluation of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. (May 2013). &#039;&#039;&#039;Oral Presentation presented at: Heart Rhythm Society. Late Breaking Clinical Tria&#039;&#039;&#039;l; Denver, Colorado USA. Published&lt;br /&gt;
&lt;br /&gt;
2008: Guha A, Vaidya V, Shah M, Sanghai S, Shukla E, Parikh R, Gala P, Shingada A, Goray A, Mansukhani S, Shah V. (2008, March). &#039;&#039;&#039;Phantom limb and the role of Virtual Mirror Box.&#039;&#039;&#039; Oral Presentation presented at: &#039;&#039;Bombay Medical Congress; Mumbai&#039;&#039;, India.&lt;br /&gt;
&lt;br /&gt;
2007: Guha A, Agarwal A, Sawant A, Surekha S, Krishnamoorty S et al. (2007, March). &#039;&#039;&#039;Paediatric HIV.&#039;&#039;&#039; Oral Presentation presented at: &#039;&#039;Bombay Medical Congress&#039;&#039;; Mumbai, India.&lt;br /&gt;
&lt;br /&gt;
==Editorial Boards==&lt;br /&gt;
&lt;br /&gt;
Associate Editor in Chief for [[Ventricular Tachycardia]] Section of wikidoc&lt;br /&gt;
&lt;br /&gt;
==Internet Educational Sites==&lt;br /&gt;
&lt;br /&gt;
Sharing information about boards and good literature is my passion http://www.avirupguha.co.nr&lt;br /&gt;
&lt;br /&gt;
[[Category:Medical Graduate]]&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=User:Avirupguha&amp;diff=1464102</id>
		<title>User:Avirupguha</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=User:Avirupguha&amp;diff=1464102"/>
		<updated>2018-04-19T12:48:39Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: /* Publications */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;[[Image:guha.jpg|right|Avirup Guha, M.B.B.S.]]&lt;br /&gt;
&#039;&#039;&#039;Avirup Guha, M.B.B.S.&#039;&#039;&#039;, Associate Editor-in-Chief of [[Ventricular Tachycardia]], WikiDoc Foundation&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Contact:&#039;&#039;&#039; mailto:avirup.guha@gmail.com; &lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Download This Brief Bio as a PDF:&#039;&#039;&#039; [[media:Guha.pdf|CV]]&lt;br /&gt;
&lt;br /&gt;
__NOTOC__&lt;br /&gt;
----&lt;br /&gt;
Hi everyone coming to my page. I am Avirup Guha, a medical student from Seth G.S. Medical College, Mumbai, India batch of 2005. I have been trying to keep up the good work at all places-college and from home.&lt;br /&gt;
My subjects of interest – Cardiology, Gastroenterology and Radiology.&lt;br /&gt;
&lt;br /&gt;
==Education==&lt;br /&gt;
&lt;br /&gt;
I finished my training from Seth G.S. Medical College, Mumbai, India. I passed out with M.B.B.S. degree in May 2011. I did around 8 months of rotations in various US institutions in varied environments for US clinical experience.&lt;br /&gt;
&lt;br /&gt;
==Research==&lt;br /&gt;
&lt;br /&gt;
2009: June—November Seth G.S. Medical college, Mumbai,( Dr. Shobna Bhatia, Head of the Department: Department of Gastroenterology) &#039;&#039;&#039;&amp;quot;Quality of nutrition, especially medium chain fatty acids, in patients of alcoholic liver disease as compared to alcoholics without liver disease&amp;quot;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2008: January—2009: October Seth G.S. Medical college, Mumbai,( Dr. Prafulla Kerkar, Head of the Department: Department of Cardiology) &#039;&#039;&#039;“To study the clinical profile and predictors of recurrence in patients with Stable Ventricular Tachycardia”&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2006: September—2007: March Seth G.S. Medical college, Mumbai,( Dr. Nirmala Rege, Professor: Pharmacology) &#039;&#039;&#039;“Immunostimulatory Potential of Indian Medicinal Plants on Thymocytes of Swiss Albino Mice”&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
==Research Allowance==&lt;br /&gt;
&lt;br /&gt;
2009: Indian Council of Medical Research, Short Term Studentship (Pharmacology)&lt;br /&gt;
&lt;br /&gt;
==Publications==&lt;br /&gt;
&lt;br /&gt;
2018: Foraker R, Guha A, Chang H, O’Brien E, Bower J, Crouser E, Rosamond W, Raman SV. Survival after MI in a Community Cohort Study: Contribution of Comorbidities in NSTEMI. Glob Heart. 2018 Feb 3. pii: S2211-8160(18)30002-4. (PMID: 29409724)&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Snider MJ, Boyd M, Afzal M, Badin A, Godara H, Liu Z, Tyler J, Weiss R, Kalbfleisch S, Augostini R, Hummel J, Houmsse M, Daoud EG. Initiation and Outcomes with Class Ic Antiarrhythmic Drug Therapy. Indian Pacing Electrophysiol J. 2017 Dec 7. pii: S0972-6292(17)30192-4. doi: 10.1016/j.ipej.2017.12.001. [Epub ahead of print] (PMID: 29225010)&lt;br /&gt;
&lt;br /&gt;
2017: Liu E, Guha A, Jia K, Ayers AM, Boudoulas KD, Bertino E, Franco V. Cardiogenic shock in a patient being treated with Atezolizumab for metastatic non-small cell lung cancer. Lung Cancer. 2017 Jul 29. pii: S0169-5002(17)30416-6. doi: 10.1016/j.lungcan.2017.07.028. [Epub ahead of print] (PMID: 28780994, 29292070)&lt;br /&gt;
&lt;br /&gt;
2017: Wiczer TE, Levine LB, Brumbaugh J, Coggins J, Zhao Q, Ruppert AS, Rogers K, McCoy A, Mousa L, Guha A, Maddocks K, Christian B, Andritsos LA, Jaglowski S, Devine S, Baiocchi R, Woyach J, Jones J, Grever M, Blum KA, Byrd JC, Awan FT: Incidence, Risk Factors, and Management of Atrial Fibrillation in Patients Receiving Ibrutinib for Hematologic Malignancies. Blood Adv. 2017 1:1739-1748; doi: 10.1182/bloodadvances.2017009720 (PMID: 29296820)&lt;br /&gt;
&lt;br /&gt;
2017: Dunleavy M, Guha A, Ernst K, Sullivan M, Voelkel AJ, Raman SV, Baker C, Dean S. Running without a vein: Congenital Absence of the Right Common Iliac Vein. Int J Cardiovasc Imaging. 2017. Accepted for publication.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Gao X, Dunleavy M, Liu E, Patel D, Fedorov VV, Daoud EG. Eleven-year trends of inpatient pacemaker implantation in patients diagnosed with sick sinus syndrome. J Cardiovasc Electrophysiol. 2017 May 4. doi: 10.1111/jce.13248. [Epub ahead of print] (PMID: 28471545)&lt;br /&gt;
&lt;br /&gt;
2016: Li N, Csepe TA, Hansen BJ, Sul LV, Kalyanasundaram A, Zakharkin SO, Zhao J, Guha A, Van Wagoner DR, Kilic A, Mohler PJ, Janssen PM, Biesiadecki BJ, Hummel JD, Weiss R, Fedorov VV: Adenosine-Induced Atrial Fibrillation: Localized Reentrant Drivers in Lateral Right Atria due to Heterogeneous Expression of Adenosine A1 Receptors and GIRK4 Subunits in the Human Heart. Circulation. 2016 Aug 9;134 (6):486-98. (PMID: 27462069)&lt;br /&gt;
&lt;br /&gt;
2016: O&#039;Connor PM, Guha A, Stilphen CA, Sun J, Jin C: Proton channels and renal hypertensive injury: a key piece of the Dahl salt-sensitive rat puzzle? Am J Physiol Regul Integr Comp Physiol. 2016 Feb 3:ajpregu.00115.2015. (PMID: 26843580)&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Merchen LA: Cerebral Cryptococcoma – but Why? J Kuwait Med Assoc. 2015 November. 47(4):346-347.&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Maddox WR, Colombo R, Nahman NS Jr, Kintziger KW, Waller JL, Diamond M, Murphy M, Kheda M, Litwin SE, Sorrentino RA. Evaluation Of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Heart Rhythm. 2015 Aug 4. pii: S1547-5271(15)01017-6. (PMID: 26253036)&lt;br /&gt;
&lt;br /&gt;
2015: Ayoola R, Guha A, Daram SR: Gastrointestinal Bleeding as the Initial Presentation of HIV/AIDS. Gastrointest Endosc. 2015 Apr 25. pii: S0016-5107(15)02117-3. (PMID: 25922245)&lt;br /&gt;
&lt;br /&gt;
2014: Jin C, Sun J, Stilphen CA, Smith SME, Ocasio H, Bermingham B, Darji S, Guha A, Patel R, Geurts AM, Jacob HJ, Lambert NA, O’Connor PM: HV1 ACTS AS A sodium SENSOR AND promotes superoxide production in medullary thick ascending limb of Dahl SALT-SENSITIVE rats. Hypertension. 2014 Sep; 64(3):541-50. (PMID: 24935944)&lt;br /&gt;
&lt;br /&gt;
2014: Murphy M, Krothapalli S, Cuellar J, Kanjanauthai S, Heeke B, Sharma P, Guha A, Barnes VA, Litwin S, Sharma G: Prognostic Value of Normal Stress Echocardiography in Obese Patients. J Obes. 2014 Aug; 2014:419724. (PMID: 25258682)&lt;br /&gt;
&lt;br /&gt;
2014: Guha A, Kulkarni HS: ATS Patient Series: What is Histoplasmosis? Am J of Resir Crit Care Med. 2012 Apr; 185:1–2.&lt;br /&gt;
&lt;br /&gt;
2012: Madhwal S, Goldberg J, Barcena J, Guha A, Gogate P, Cmolik B, Elgudin Y: An Unusual Cause of Acute Mitral Regurgitation: Idiopathic Hypereosinophilic Syndrome. Ann Tho Surg. 2012 Mar; 93(3):974-7. (PMID: 22364989).&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Poster/Online Presentations (published and unpublished)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2018: Guha A, Cardona A, Nagaraja HN, Raman SV, Zareba KM. Prognostic value of midwall fibrosis in patients with preserved ejection fraction and structurally normal heart (pilot study). Accepted for poster at CMR 2018, Barcelona, Spain. Published online - &amp;lt;nowiki&amp;gt;http://cmr2018.org/wp-content/uploads/2018/01/Abstract-Supplement-Book.pdf&amp;lt;/nowiki&amp;gt;&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Okabe T, Buck B, Gao X, Liu E, Dunleavy M, Haddad D, Daoud EG. Short- And Mid-term Hospitalization for Recurrence Of Atrial Fibrillation After Catheter Ablation In Obese Patients. (2017 November) American Association of Cardiologist of Indian Origin Annual Meeting, Anaheim, California, USA. Unpublished.&lt;br /&gt;
&lt;br /&gt;
2017: Franco DA, Gao X, Guha A, Buck B, Patel D, Snider MJ, Boyd M, Afzal M, Badin A, Godara H, Liu Z, Tyler J, Weiss R, Kalbfleisch S, Augostini R, Hummel J, Houmsse M, Daoud EG. Initiation and Outcomes with Class Ic Antiarrhythmic Drug Therapy. (2017 October) Ohio ACC meeting, Columbus, Ohio, USA. Unpublished.&lt;br /&gt;
&lt;br /&gt;
2017: Briston D, Guha A, Zubizarreta N, Daniels C, Bradley EA. Pregnancy in Congenital Heart Disease: Analysis of Maternal Cardiovascular Hospitalizations. (2017 September) Annual International Symposium on Adult Congenital Heart Disease, Cincinnati, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Dunleavy M, Guha A, Ernst K, Sullivan M, Voelkel AJ, Raman SV, Baker C, Dean S. Running without a vein: Congenital Absence of the Right Common Iliac Vein. (2017 June) NASCI Case in Point. Accepted for online publication.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Gao X, Dunleavy M, Liu E, Patel D, Fedorov VV, Daoud EG. Eleven year trends of inpatient pacemaker implantation in patients diagnosed with sick sinus syndrome. (2017 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Houmsse M, Snider M, Daoud EG. Exercise Testing in Patients Treated with Class IC Antiarrhythmic Drug. (2017 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Gao X, Awan F, Hofmeister C, Daoud EG, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Atrial Fibrillation and Concurrent Amyloidosis. (2017 April): OSUCCC – James Annual Scientific Meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Chang H, O’Brien E, Bower J, Crouser E, Rosamond W, Raman SV, Foraker R. Community-based mortality risk due to acute coronary syndromes: An ARIC study. (2016 October): Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A, Bower JK, Foraker R, Smith S. Ventricular Tachycardia and Sick Sinus Syndrome in Neoplasia. (2016 May) OSU Internal Medicine Research day, Research Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Dooling PC, Ramsey ML, Guha A, Sofowora G. Connective Tissue Disease Presenting as Pericardial Effusion with Tamponade. (2016 May) OSU Internal Medicine Research day, Case Poster, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Ruden E, Raman S. Unusual cardiac iron overload in a sickle cell disease patient. (2015 October): Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2014: Baker S, Guha A, Mitulescu L, Murphy M, Cuomo J, Haydour Q, Sorrentino RA. (October 2014). Slow Excitation: The remarkable presentation of Wolff-Parkinson-White Anomaly with bradycardia: Georgia ACP meeting; Lake Lanier, Georgia, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman Jr NS, Kintziger K, Kheda M, Sorrentino RA. (November 2013). Evaluation of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Oral Presentation presented at: Georgia ACC fellows presentation; Lake Oconee, Georgia USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
==Oral Presentations==&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Buck B, Gao X, Haddad D, Liu E, Dunleavy M, Efebera Y, Baliga R. Trends in Hospitalization of Patients with Acute Coronary Syndrome and Concurrent Amyloidosis. (2017 October) Ohio ACC meeting, Columbus, Ohio, USA. Unpublished&lt;br /&gt;
&lt;br /&gt;
2016: Guha A. Sinoatrial node: Bench to bedside: OSU Cardiology Grand Rounds, Columbus, Ohio, USA. (2016 February) Unpublished&lt;br /&gt;
&lt;br /&gt;
2013: Guha A, Maddox WR, Colombo R, Nahman Jr NS, Kintziger K, Kheda M, Sorrentino RA. Evaluation of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. (May 2013). &#039;&#039;&#039;Oral Presentation presented at: Heart Rhythm Society. Late Breaking Clinical Tria&#039;&#039;&#039;l; Denver, Colorado USA. Published&lt;br /&gt;
&lt;br /&gt;
2008: Guha A, Vaidya V, Shah M, Sanghai S, Shukla E, Parikh R, Gala P, Shingada A, Goray A, Mansukhani S, Shah V. (2008, March). &#039;&#039;&#039;Phantom limb and the role of Virtual Mirror Box.&#039;&#039;&#039; Oral Presentation presented at: &#039;&#039;Bombay Medical Congress; Mumbai&#039;&#039;, India.&lt;br /&gt;
&lt;br /&gt;
2007: Guha A, Agarwal A, Sawant A, Surekha S, Krishnamoorty S et al. (2007, March). &#039;&#039;&#039;Paediatric HIV.&#039;&#039;&#039; Oral Presentation presented at: &#039;&#039;Bombay Medical Congress&#039;&#039;; Mumbai, India.&lt;br /&gt;
&lt;br /&gt;
==Editorial Boards==&lt;br /&gt;
&lt;br /&gt;
Associate Editor in Chief for [[Ventricular Tachycardia]] Section of wikidoc&lt;br /&gt;
&lt;br /&gt;
==Internet Educational Sites==&lt;br /&gt;
&lt;br /&gt;
Sharing information about boards and good literature is my passion http://www.avirupguha.co.nr&lt;br /&gt;
&lt;br /&gt;
[[Category:Medical Graduate]]&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=User:Avirupguha&amp;diff=1464100</id>
		<title>User:Avirupguha</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=User:Avirupguha&amp;diff=1464100"/>
		<updated>2018-04-19T12:32:09Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: /* Publications */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;[[Image:guha.jpg|right|Avirup Guha, M.B.B.S.]]&lt;br /&gt;
&#039;&#039;&#039;Avirup Guha, M.B.B.S.&#039;&#039;&#039;, Associate Editor-in-Chief of [[Ventricular Tachycardia]], WikiDoc Foundation&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Contact:&#039;&#039;&#039; mailto:avirup.guha@gmail.com; &lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Download This Brief Bio as a PDF:&#039;&#039;&#039; [[media:Guha.pdf|CV]]&lt;br /&gt;
&lt;br /&gt;
__NOTOC__&lt;br /&gt;
----&lt;br /&gt;
Hi everyone coming to my page. I am Avirup Guha, a medical student from Seth G.S. Medical College, Mumbai, India batch of 2005. I have been trying to keep up the good work at all places-college and from home.&lt;br /&gt;
My subjects of interest – Cardiology, Gastroenterology and Radiology.&lt;br /&gt;
&lt;br /&gt;
==Education==&lt;br /&gt;
&lt;br /&gt;
I finished my training from Seth G.S. Medical College, Mumbai, India. I passed out with M.B.B.S. degree in May 2011. I did around 8 months of rotations in various US institutions in varied environments for US clinical experience.&lt;br /&gt;
&lt;br /&gt;
==Research==&lt;br /&gt;
&lt;br /&gt;
2009: June—November Seth G.S. Medical college, Mumbai,( Dr. Shobna Bhatia, Head of the Department: Department of Gastroenterology) &#039;&#039;&#039;&amp;quot;Quality of nutrition, especially medium chain fatty acids, in patients of alcoholic liver disease as compared to alcoholics without liver disease&amp;quot;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2008: January—2009: October Seth G.S. Medical college, Mumbai,( Dr. Prafulla Kerkar, Head of the Department: Department of Cardiology) &#039;&#039;&#039;“To study the clinical profile and predictors of recurrence in patients with Stable Ventricular Tachycardia”&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2006: September—2007: March Seth G.S. Medical college, Mumbai,( Dr. Nirmala Rege, Professor: Pharmacology) &#039;&#039;&#039;“Immunostimulatory Potential of Indian Medicinal Plants on Thymocytes of Swiss Albino Mice”&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
==Research Allowance==&lt;br /&gt;
&lt;br /&gt;
2009: Indian Council of Medical Research, Short Term Studentship (Pharmacology)&lt;br /&gt;
&lt;br /&gt;
==Publications==&lt;br /&gt;
&lt;br /&gt;
2018: Foraker R, Guha A, Chang H, O’Brien E, Bower J, Crouser E, Rosamond W, Raman SV. Survival after MI in a Community Cohort Study: Contribution of Comorbidities in NSTEMI. Glob Heart. 2018 Feb 3. pii: S2211-8160(18)30002-4. (PMID: 29409724)&lt;br /&gt;
&lt;br /&gt;
2017: Gao X, Guha A, Buck B, Patel D, Snider MJ, Boyd M, Afzal M, Badin A, Godara H, Liu Z, Tyler J, Weiss R, Kalbfleisch S, Augostini R, Hummel J, Houmsse M, Daoud EG. Initiation and Outcomes with Class Ic Antiarrhythmic Drug Therapy. Indian Pacing Electrophysiol J. 2017 Dec 7. pii: S0972-6292(17)30192-4. doi: 10.1016/j.ipej.2017.12.001. [Epub ahead of print] (PMID: 29225010)&lt;br /&gt;
&lt;br /&gt;
2017: Liu E, Guha A, Jia K, Ayers AM, Boudoulas KD, Bertino E, Franco V. Cardiogenic shock in a patient being treated with Atezolizumab for metastatic non-small cell lung cancer. Lung Cancer. 2017 Jul 29. pii: S0169-5002(17)30416-6. doi: 10.1016/j.lungcan.2017.07.028. [Epub ahead of print] (PMID: 28780994, 29292070)&lt;br /&gt;
&lt;br /&gt;
2017: Wiczer TE, Levine LB, Brumbaugh J, Coggins J, Zhao Q, Ruppert AS, Rogers K, McCoy A, Mousa L, Guha A, Maddocks K, Christian B, Andritsos LA, Jaglowski S, Devine S, Baiocchi R, Woyach J, Jones J, Grever M, Blum KA, Byrd JC, Awan FT: Incidence, Risk Factors, and Management of Atrial Fibrillation in Patients Receiving Ibrutinib for Hematologic Malignancies. Blood Adv. 2017 1:1739-1748; doi: 10.1182/bloodadvances.2017009720 (PMID: 29296820)&lt;br /&gt;
&lt;br /&gt;
2017: Dunleavy M, Guha A, Ernst K, Sullivan M, Voelkel AJ, Raman SV, Baker C, Dean S. Running without a vein: Congenital Absence of the Right Common Iliac Vein. Int J Cardiovasc Imaging. 2017. Accepted for publication.&lt;br /&gt;
&lt;br /&gt;
2017: Guha A, Xiang X, Haddad D, Buck B, Gao X, Dunleavy M, Liu E, Patel D, Fedorov VV, Daoud EG. Eleven-year trends of inpatient pacemaker implantation in patients diagnosed with sick sinus syndrome. J Cardiovasc Electrophysiol. 2017 May 4. doi: 10.1111/jce.13248. [Epub ahead of print] (PMID: 28471545)&lt;br /&gt;
&lt;br /&gt;
2016: Li N, Csepe TA, Hansen BJ, Sul LV, Kalyanasundaram A, Zakharkin SO, Zhao J, Guha A, Van Wagoner DR, Kilic A, Mohler PJ, Janssen PM, Biesiadecki BJ, Hummel JD, Weiss R, Fedorov VV: Adenosine-Induced Atrial Fibrillation: Localized Reentrant Drivers in Lateral Right Atria due to Heterogeneous Expression of Adenosine A1 Receptors and GIRK4 Subunits in the Human Heart. Circulation. 2016 Aug 9;134 (6):486-98. (PMID: 27462069)&lt;br /&gt;
&lt;br /&gt;
2016: O&#039;Connor PM, Guha A, Stilphen CA, Sun J, Jin C: Proton channels and renal hypertensive injury: a key piece of the Dahl salt-sensitive rat puzzle? Am J Physiol Regul Integr Comp Physiol. 2016 Feb 3:ajpregu.00115.2015. (PMID: 26843580)&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Merchen LA: Cerebral Cryptococcoma – but Why? J Kuwait Med Assoc. 2015 November. 47(4):346-347.&lt;br /&gt;
&lt;br /&gt;
2015: Guha A, Maddox WR, Colombo R, Nahman NS Jr, Kintziger KW, Waller JL, Diamond M, Murphy M, Kheda M, Litwin SE, Sorrentino RA. Evaluation Of Cardiac Implantable Electronic Device Infection Outcomes From A Large End Stage Renal Disease Database. Heart Rhythm. 2015 Aug 4. pii: S1547-5271(15)01017-6. (PMID: 26253036)&lt;br /&gt;
&lt;br /&gt;
2015: Ayoola R, Guha A, Daram SR: Gastrointestinal Bleeding as the Initial Presentation of HIV/AIDS. Gastrointest Endosc. 2015 Apr 25. pii: S0016-5107(15)02117-3. (PMID: 25922245)&lt;br /&gt;
&lt;br /&gt;
2014: Jin C, Sun J, Stilphen CA, Smith SME, Ocasio H, Bermingham B, Darji S, Guha A, Patel R, Geurts AM, Jacob HJ, Lambert NA, O’Connor PM: HV1 ACTS AS A sodium SENSOR AND promotes superoxide production in medullary thick ascending limb of Dahl SALT-SENSITIVE rats. Hypertension. 2014 Sep; 64(3):541-50. (PMID: 24935944)&lt;br /&gt;
&lt;br /&gt;
2014: Murphy M, Krothapalli S, Cuellar J, Kanjanauthai S, Heeke B, Sharma P, Guha A, Barnes VA, Litwin S, Sharma G: Prognostic Value of Normal Stress Echocardiography in Obese Patients. J Obes. 2014 Aug; 2014:419724. (PMID: 25258682)&lt;br /&gt;
&lt;br /&gt;
2014: Guha A, Kulkarni HS: ATS Patient Series: What is Histoplasmosis? Am J of Resir Crit Care Med. 2012 Apr; 185:1–2.&lt;br /&gt;
&lt;br /&gt;
2012: Madhwal S, Goldberg J, Barcena J, Guha A, Gogate P, Cmolik B, Elgudin Y: An Unusual Cause of Acute Mitral Regurgitation: Idiopathic Hypereosinophilic Syndrome. Ann Tho Surg. 2012 Mar; 93(3):974-7. (PMID: 22364989).&lt;br /&gt;
&lt;br /&gt;
==Oral Presentations==&lt;br /&gt;
&lt;br /&gt;
2007: Guha A, Agarwal A, Sawant A, Surekha S, Krishnamoorty S et al. (2007, March). &#039;&#039;&#039;Paediatric HIV.&#039;&#039;&#039; Oral Presentation presented at: &#039;&#039;Bombay Medical Congress&#039;&#039;; Mumbai, India.&lt;br /&gt;
&lt;br /&gt;
2008: Guha A, Vaidya V, Shah M, Sanghai S, Shukla E, Parikh R, Gala P, Shingada A, Goray A, Mansukhani S, Shah V. (2008, March). &#039;&#039;&#039;Phantom limb and the role of Virtual Mirror Box.&#039;&#039;&#039; Oral Presentation presented at: &#039;&#039;Bombay Medical Congress; Mumbai&#039;&#039;, India.&lt;br /&gt;
&lt;br /&gt;
==Editorial Boards==&lt;br /&gt;
&lt;br /&gt;
Associate Editor in Chief for [[Ventricular Tachycardia]] Section of wikidoc&lt;br /&gt;
&lt;br /&gt;
==Internet Educational Sites==&lt;br /&gt;
&lt;br /&gt;
Sharing information about boards and good literature is my passion http://www.avirupguha.co.nr&lt;br /&gt;
&lt;br /&gt;
[[Category:Medical Graduate]]&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=User:Avirupguha&amp;diff=1464099</id>
		<title>User:Avirupguha</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=User:Avirupguha&amp;diff=1464099"/>
		<updated>2018-04-19T12:28:54Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: I am changing my bio to be current&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;[[Image:guha.jpg|right|Avirup Guha, M.B.B.S.]]&lt;br /&gt;
&#039;&#039;&#039;Avirup Guha, M.B.B.S.&#039;&#039;&#039;, Associate Editor-in-Chief of [[Ventricular Tachycardia]], WikiDoc Foundation&lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Contact:&#039;&#039;&#039; mailto:avirup.guha@gmail.com; &lt;br /&gt;
&lt;br /&gt;
&#039;&#039;&#039;Download This Brief Bio as a PDF:&#039;&#039;&#039; [[media:Guha.pdf|CV]]&lt;br /&gt;
&lt;br /&gt;
__NOTOC__&lt;br /&gt;
----&lt;br /&gt;
Hi everyone coming to my page. I am Avirup Guha, a medical student from Seth G.S. Medical College, Mumbai, India batch of 2005. I have been trying to keep up the good work at all places-college and from home.&lt;br /&gt;
My subjects of interest – Cardiology, Gastroenterology and Radiology.&lt;br /&gt;
&lt;br /&gt;
==Education==&lt;br /&gt;
&lt;br /&gt;
I finished my training from Seth G.S. Medical College, Mumbai, India. I passed out with M.B.B.S. degree in May 2011. I did around 8 months of rotations in various US institutions in varied environments for US clinical experience.&lt;br /&gt;
&lt;br /&gt;
==Research==&lt;br /&gt;
&lt;br /&gt;
2009: June—November Seth G.S. Medical college, Mumbai,( Dr. Shobna Bhatia, Head of the Department: Department of Gastroenterology) &#039;&#039;&#039;&amp;quot;Quality of nutrition, especially medium chain fatty acids, in patients of alcoholic liver disease as compared to alcoholics without liver disease&amp;quot;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2008: January—2009: October Seth G.S. Medical college, Mumbai,( Dr. Prafulla Kerkar, Head of the Department: Department of Cardiology) &#039;&#039;&#039;“To study the clinical profile and predictors of recurrence in patients with Stable Ventricular Tachycardia”&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
2006: September—2007: March Seth G.S. Medical college, Mumbai,( Dr. Nirmala Rege, Professor: Pharmacology) &#039;&#039;&#039;“Immunostimulatory Potential of Indian Medicinal Plants on Thymocytes of Swiss Albino Mice”&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
==Research Allowance==&lt;br /&gt;
&lt;br /&gt;
2009: Indian Council of Medical Research, Short Term Studentship (Pharmacology)&lt;br /&gt;
&lt;br /&gt;
==Publications==&lt;br /&gt;
&lt;br /&gt;
2011: Guha A, Kulkarni HS: &#039;&#039;&#039;ATS Patient Series: What is Histoplasmosis?&#039;&#039;&#039; &#039;&#039;Am J of Resir Crit Care Med&#039;&#039;. In Press.&lt;br /&gt;
&lt;br /&gt;
2011: Madhwal S, Goldberg J, Barcena J, Guha A, Gogate P, Cmolik B, Elgudin Y : &#039;&#039;&#039;An Unusual Cause of Acute Mitral Regurgitation: Idiopathic Hypereosinophilic Syndrome.&#039;&#039;&#039; &#039;&#039;Ann Tho Surg&#039;&#039;. In press.&lt;br /&gt;
&lt;br /&gt;
==Oral Presentations==&lt;br /&gt;
&lt;br /&gt;
2007: Guha A, Agarwal A, Sawant A, Surekha S, Krishnamoorty S et al. (2007, March). &#039;&#039;&#039;Paediatric HIV.&#039;&#039;&#039; Oral Presentation presented at: &#039;&#039;Bombay Medical Congress&#039;&#039;; Mumbai, India.&lt;br /&gt;
&lt;br /&gt;
2008: Guha A, Vaidya V, Shah M, Sanghai S, Shukla E, Parikh R, Gala P, Shingada A, Goray A, Mansukhani S, Shah V. (2008, March). &#039;&#039;&#039;Phantom limb and the role of Virtual Mirror Box.&#039;&#039;&#039; Oral Presentation presented at: &#039;&#039;Bombay Medical Congress; Mumbai&#039;&#039;, India.&lt;br /&gt;
&lt;br /&gt;
==Editorial Boards==&lt;br /&gt;
&lt;br /&gt;
Associate Editor in Chief for [[Ventricular Tachycardia]] Section of wikidoc&lt;br /&gt;
&lt;br /&gt;
==Internet Educational Sites==&lt;br /&gt;
&lt;br /&gt;
Sharing information about boards and good literature is my passion http://www.avirupguha.co.nr&lt;br /&gt;
&lt;br /&gt;
[[Category:Medical Graduate]]&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia&amp;diff=620329</id>
		<title>Ventricular tachycardia</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia&amp;diff=620329"/>
		<updated>2012-01-13T00:11:06Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Infobox_Disease |&lt;br /&gt;
  Name           = {{PAGENAME}} |&lt;br /&gt;
  Image          = Lead II rhythm ventricular tachycardia Vtach VT.jpg |&lt;br /&gt;
  Caption        = Lead II: rhythm, ventricular tachycardia |&lt;br /&gt;
  DiseasesDB     = 13819 |&lt;br /&gt;
  ICD10          = {{ICD10|I|47|2|i|30}} |&lt;br /&gt;
  ICD9           = {{ICD9|427.1}} |&lt;br /&gt;
  ICDO           = |&lt;br /&gt;
  OMIM           = |&lt;br /&gt;
  MedlinePlus    = |&lt;br /&gt;
  eMedicineSubj  = |&lt;br /&gt;
  eMedicineTopic = |&lt;br /&gt;
  eMedicine_mult = |&lt;br /&gt;
  MeshID         = D017180 |&lt;br /&gt;
}}&lt;br /&gt;
{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}};&#039;&#039;&#039;Associate Editor-In-Chief:&#039;&#039;&#039; {{CZ}}, [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia overview|Overview]]==&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia historical perspective|Historical Perspective]]==&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia classification|Classification]]==&lt;br /&gt;
[[Ventricular tachycardia classification#1. Classification Based Upon Morphology of Complexes|Based on Morphology of Complexes]] | [[Ventricular tachycardia classification#2. Classification Based Upon Duration of Episode|Based on Duration of Episode]] | [[Ventricular tachycardia classification#3. Classification Based Upon Symptoms|Based on Symptoms]] | [[Bundle branch reentrant ventricular tachycardia]]&lt;br /&gt;
&lt;br /&gt;
[[Ventricular tachycardia differential diagnosis|Differentials]]&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia pathophysiology|Pathophysiology]]==&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia epidemiology|Epidemiology and Demographics]]==&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia risk factors|Risk Factors]]==&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia screening|Screening]]==&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia natural history|Natural History]]==&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia causes|Causes of Ventricular tachycardia]]==&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia prognosis|Prognosis]]==&lt;br /&gt;
&lt;br /&gt;
==Diagnosis==&lt;br /&gt;
[[Ventricular tachycardia symptoms|History and Symptoms]] | [[Ventricular_tachycardia_physical_examination|Physical Examination]] | [[Ventricular tachycardia test selection guideline for the individual basis|Test selection guideline for the individual basis]] | [[Ventricular tachycardia initial laboratory tests|Laboratory Tests]] | [[Ventricular tachycardia electrocardiography|Electrocardiography]] | [[Ventricular tachycardia exercise electrocardiography|Exercise ECG]] | [[Ventricular tachycardia chest x-ray|Chest x-ray]] | [[Ventricular tachycardia perfusion scintigraphy with pharmacologic stress|Myocardial Perfusion Scintigraphy with Pharmacologic Stress]] | [[Ventricular tachycardia myocardial perfusion scintigraphy|Myocardial Perfusion Scintigraphy with Thallium]] | [[Ventricular tachycardia echocardiography|Echocardiography]] | [[Ventricular tachycardia exercise echocardiography|Exercise Echocardiography]] | [[Ventricular tachycardia positron emission tomography (PET)|Positron Emission Tomography]] | [[Ventricular tachycardia ambulatory ST segment monitoring|Ambulatory ST Segment Monitoring]] | [[Ventricular tachycardia electron beam tomography|Electron Beam Tomography]] | [[Ventricular tachycardia cardiac magnetic resonance imaging|Cardiac Magnetic Resonance Imaging]] | [[Ventricular tachycardia coronary angiography|Coronary Angiography]]&lt;br /&gt;
&lt;br /&gt;
==Treatment==&lt;br /&gt;
[[Ventricular tachycardia electrical cardioversion|Electrical Cardioversion / Defibrillation]] | [[Ventricular tachycardia antiarrhythmic drug therapy|Antiarrhythmic drug therapy]] | [[Ventricular tachycardia surgery|Surgery]] | [[Ventricular tachycardia guidelines in treatment|Guidelines in Treatment]]&lt;br /&gt;
&lt;br /&gt;
==Guidelines for Asymptomatic Patients==&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia landmark trials|Landmark Trials]]==&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
==Ventricular tachycardia in the News==&lt;br /&gt;
&lt;br /&gt;
==External Links==&lt;br /&gt;
* [http://en.ecgpedia.org ECGpedia: Course for interpretation of ECG]&lt;br /&gt;
* [http://www.anaesthetist.com/icu/organs/heart/ecg/ The whole ECG - A basic ECG primer]&lt;br /&gt;
* [http://www.ecglibrary.com 12-lead ECG library]&lt;br /&gt;
* [http://www.ecgsim.org Simulation tool to demonstrate and study the relation between the electric activity of the heart and the ECG]&lt;br /&gt;
* [http://heartcenter.seattlechildrens.org/what_to_expect/electrocardiogram.asp ECG information from Children&#039;s Hospital Heart Center, Seattle]&lt;br /&gt;
* [http://0-www.nhlbi.nih.gov.innopac.up.ac.za:80/health/dci/Diseases/ekg/ekg_what.html National Heart, Lung, and Blood Institute, Diseases and Conditions Index]&lt;br /&gt;
* [http://www.ecglibrary.com/ecghist.html A history of electrocardiography]&lt;br /&gt;
* [http://www.health.gov.mt/impaedcard/issue/issue1/ipc00103.htm EKG Interpretations in infants and children]&lt;br /&gt;
&lt;br /&gt;
[[Category:Disease]]&lt;br /&gt;
[[Category:Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
[[Category:Emergency medicine]]&lt;br /&gt;
[[Category:Intensive care medicine]]&lt;br /&gt;
&lt;br /&gt;
[[Category:Up-To-Date]]&lt;br /&gt;
[[Category:Up-To-Date cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia&amp;diff=620328</id>
		<title>Ventricular tachycardia</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia&amp;diff=620328"/>
		<updated>2012-01-13T00:10:26Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Infobox_Disease |&lt;br /&gt;
  Name           = {{PAGENAME}} |&lt;br /&gt;
  Image          = Lead II rhythm ventricular tachycardia Vtach VT.jpg |&lt;br /&gt;
  Caption        = Lead II: rhythm, ventricular tachycardia |&lt;br /&gt;
  DiseasesDB     = 13819 |&lt;br /&gt;
  ICD10          = {{ICD10|I|47|2|i|30}} |&lt;br /&gt;
  ICD9           = {{ICD9|427.1}} |&lt;br /&gt;
  ICDO           = |&lt;br /&gt;
  OMIM           = |&lt;br /&gt;
  MedlinePlus    = |&lt;br /&gt;
  eMedicineSubj  = |&lt;br /&gt;
  eMedicineTopic = |&lt;br /&gt;
  eMedicine_mult = |&lt;br /&gt;
  MeshID         = D017180 |&lt;br /&gt;
}}&lt;br /&gt;
{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}};&#039;&#039;&#039;Associate Editor-In-Chief:&#039;&#039;&#039; {{CZ}}, [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia overview|Overview]]==&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia historical perspective|Historical Perspective]]==&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia classification|Classification]]==&lt;br /&gt;
[[Ventricular tachycardia classification#1. Classification Based Upon Morphology of Complexes|Based on Morphology of Complexes]] | [[Ventricular tachycardia classification#2. Classification Based Upon Duration of Episode|Based on Duration of Episode]] | [[Ventricular tachycardia classification#3. Classification Based Upon Symptoms|Based on Symptoms]] | [[Bundle branch reentrant ventricular tachycardia]]&lt;br /&gt;
&lt;br /&gt;
[[Ventricular tachycardia differential diagnosis|Differentials]]&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia pathophysiology|Pathophysiology]]==&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia epidemiology|Epidemiology and Demographics]]==&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia risk factors|Risk Factors]]==&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia screening|Screening]]==&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia natural history|Natural History]]==&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia causes|Causes of Ventricular tachycardia]]==&lt;br /&gt;
&lt;br /&gt;
==[[Ventricular tachycardia prognosis|Prognosis]]==&lt;br /&gt;
&lt;br /&gt;
==Diagnosis==&lt;br /&gt;
[[Ventricular tachycardia symptoms|History and Symptoms]] | [[Ventricular_tachycardia_physical_examination|Physical Examination]] | [[Ventricular tachycardia test selection guideline for the individual basis|Test selection guideline for the individual basis]] | [[Ventricular tachycardia initial laboratory tests|Laboratory Tests]] | [[Ventricular tachycardia electrocardiography|Electrocardiography]] | [[Ventricular tachycardia exercise electrocardiography|Exercise ECG]] | [[Ventricular tachycardia chest x-ray|Chest x-ray]] | [[Ventricular tachycardia perfusion scintigraphy with pharmacologic stress|Myocardial Perfusion Scintigraphy with Pharmacologic Stress]] | [[Ventricular tachycardia myocardial perfusion scintigraphy|Myocardial Perfusion Scintigraphy with Thallium]] | [[Ventricular tachycardia echocardiography|Echocardiography]] | [[Ventricular tachycardia exercise echocardiography|Exercise Echocardiography]] | [[Ventricular tachycardia positron emission tomography (PET)|Positron Emission Tomography]] | [[Ventricular tachycardia ambulatory ST segment monitoring|Ambulatory ST Segment Monitoring]] | [[Ventricular tachycardia electron beam tomography|Electron Beam Tomography]] | [[Ventricular tachycardia cardiac magnetic resonance imaging|Cardiac Magnetic Resonance Imaging]] | [[Ventricular tachycardia coronary angiography|Coronary Angiography]]&lt;br /&gt;
&lt;br /&gt;
==Treatment==&lt;br /&gt;
[[Ventricular tachycardia electrical cardioversion|Electrical Cardioversion / Defibrillation]] | [[Ventricular tachycardia antiarrhythmic drug therapy|Antiarrhythmic drug therapy]] | [[Ventricular tachycardia surgery|Surgery]] | [[Ventricular tachycardia guidelines in treatment|Guidelines in Treatment]]&lt;br /&gt;
&lt;br /&gt;
==Guidelines for Asymptomatic Patients==&lt;br /&gt;
&lt;br /&gt;
==[[Landmark Trials|Landmark Trials]]==&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
==Ventricular tachycardia in the News==&lt;br /&gt;
&lt;br /&gt;
==External Links==&lt;br /&gt;
* [http://en.ecgpedia.org ECGpedia: Course for interpretation of ECG]&lt;br /&gt;
* [http://www.anaesthetist.com/icu/organs/heart/ecg/ The whole ECG - A basic ECG primer]&lt;br /&gt;
* [http://www.ecglibrary.com 12-lead ECG library]&lt;br /&gt;
* [http://www.ecgsim.org Simulation tool to demonstrate and study the relation between the electric activity of the heart and the ECG]&lt;br /&gt;
* [http://heartcenter.seattlechildrens.org/what_to_expect/electrocardiogram.asp ECG information from Children&#039;s Hospital Heart Center, Seattle]&lt;br /&gt;
* [http://0-www.nhlbi.nih.gov.innopac.up.ac.za:80/health/dci/Diseases/ekg/ekg_what.html National Heart, Lung, and Blood Institute, Diseases and Conditions Index]&lt;br /&gt;
* [http://www.ecglibrary.com/ecghist.html A history of electrocardiography]&lt;br /&gt;
* [http://www.health.gov.mt/impaedcard/issue/issue1/ipc00103.htm EKG Interpretations in infants and children]&lt;br /&gt;
&lt;br /&gt;
[[Category:Disease]]&lt;br /&gt;
[[Category:Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
[[Category:Emergency medicine]]&lt;br /&gt;
[[Category:Intensive care medicine]]&lt;br /&gt;
&lt;br /&gt;
[[Category:Up-To-Date]]&lt;br /&gt;
[[Category:Up-To-Date cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=620327</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=620327"/>
		<updated>2012-01-13T00:07:33Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;CASCADE(The Cardiac Arrest in Seatle Conventional Versus Amiodarone Drug Evaluation study)&amp;lt;ref name=&amp;quot;pmid8237833&amp;quot;&amp;gt;{{cite journal| author=Greene HL| title=The CASCADE Study: randomized antiarrhythmic drug therapy in survivors of cardiac arrest in Seattle. CASCADE Investigators. | journal=Am J Cardiol | year= 1993 | volume= 72 | issue= 16 | pages= 70F-74F | pmid=8237833 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: [[Amiodarone]] vs conventional therapy in patients with/without AICD&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 228 [[Amiodarone]]: 113 conventional antiarrhythmic drugs: 115([[quinidine]] (n=33), [[procainamide]] (n = 26), combination therapy (n = 17), [[flecainide]] (n = 12). AICD: 105 (Amiodarone: 53, Conventional therapy: 52)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 13% more survival in patient population at the primary end point (total cardiac mortality, resuscitated cardiac arrest due to ventricular fibrillation, and syncopal Implanted defibrillator shocks) at the end of 6 years. (p=0.007).  With AICD 16% survival more at the primary end point( shocks preceded by complete syncope)(p=0.032) conclusively showing superiority of Amidarone over convetional therapy in secondary prevention.&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039; ESVEM (Electrophysiologic Study Versus Electrocardiographic Monitoring for Selection of Antiarrhythmic Therapy of Ventricular Tachyarrhythmias)&amp;lt;ref name=&amp;quot;pmid8332149&amp;quot;&amp;gt;{{cite journal| author=Mason JW| title=A comparison of electrophysiologic testing with Holter monitoring to predict antiarrhythmic-drug efficacy for ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. | journal=N Engl J Med | year= 1993 | volume= 329 | issue= 7 | pages= 445-51 | pmid=8332149 | doi=10.1056/NEJM199308123290701 | pmc= | url= }} &amp;lt;/ref&amp;gt;&amp;lt;ref name=&amp;quot;pmid8332150&amp;quot;&amp;gt;{{cite journal| author=Mason JW| title=A comparison of seven antiarrhythmic drugs in patients with ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. | journal=N Engl J Med | year= 1993 | volume= 329 | issue= 7 | pages= 452-8 | pmid=8332150 | doi=10.1056/NEJM199308123290702 | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: EP testing and Holter monitor of 7 antiarrhythmics (imipramine, mexiletine, procainamide, quinidine, sotalol, pirmenol, propafenone)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  486 patients were randomized and 296 patients were eventually followed up.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 33% in all 296 and 34% in Sotalol group&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  No difference between Holter- and EP-guided groups. Sotalol group had lowest recurrence rate of VT (risk ratio, 0.43; 95 percent confidence interval, 0.29 to 0.62; p&amp;lt;0.001), arrhythmic death (risk ratio, 0.50; 95 percent confidence interval, 0.26 to 0.96; P = 0.04), total death (risk ratio, 0.50; 95 percent confidence interval, 0.30 to 0.80; P = 0.004).&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&amp;lt;ref name=&amp;quot;pmid9411221&amp;quot;&amp;gt;{{cite journal| author=| title=A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. The Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators. | journal=N Engl J Med | year= 1997 | volume= 337 | issue= 22 | pages= 1576-83 | pmid=9411221 | doi=10.1056/NEJM199711273372202 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&amp;lt;ref name=&amp;quot;pmid10725290&amp;quot;&amp;gt;{{cite journal| author=Connolly SJ, Gent M, Roberts RS, Dorian P, Roy D, Sheldon RS et al.| title=Canadian implantable defibrillator study (CIDS) : a randomized trial of the implantable cardioverter defibrillator against amiodarone. | journal=Circulation | year= 2000 | volume= 101 | issue= 11 | pages= 1297-302 | pmid=10725290 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&amp;lt;ref name=&amp;quot;pmid10942742&amp;quot;&amp;gt;{{cite journal| author=Kuck KH, Cappato R, Siebels J, Rüppel R| title=Randomized comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from cardiac arrest : the Cardiac Arrest Study Hamburg (CASH). | journal=Circulation | year= 2000 | volume= 102 | issue= 7 | pages= 748-54 | pmid=10942742 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039; BHAT  ( β-Blocker Heart Attack Trial)&amp;lt;ref name=&amp;quot;pmid7038157&amp;quot;&amp;gt;{{cite journal| author=| title=A randomized trial of propranolol in patients with acute myocardial infarction. I. Mortality results. | journal=JAMA | year= 1982 | volume= 247 | issue= 12 | pages= 1707-14 | pmid=7038157 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039; : multicenter, randomized, double-blind, and placebo-controlled trial designed to test whether the regular administration of propranolol hydrochloride to men and women who had experienced at least one myocardial infarction would result in a significant reduction in total mortality during a two- to four-year period.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 3837, Propanolol: 1916, Placebo: 1921 persons, five to 21 days after the infarction.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Total mortality during the average 25-month follow-up period was 7.2% in the propranolol group and 9.8% in the placebo group. Arteriosclerotic heart disease (ASHD) mortality was 6.2% in the propranolol group and 8.5% in the placebo group. &lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CAST (The Cardiac Arrhythmia Suppression Trial)&amp;lt;ref name=&amp;quot;pmid1900101&amp;quot;&amp;gt;{{cite journal| author=Echt DS, Liebson PR, Mitchell LB, Peters RW, Obias-Manno D, Barker AH et al.| title=Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. | journal=N Engl J Med | year= 1991 | volume= 324 | issue= 12 | pages= 781-8 | pmid=1900101 | doi=10.1056/NEJM199103213241201 | pmc= | url= }} &amp;lt;/ref&amp;gt;&amp;lt;ref name=&amp;quot;pmid1377359&amp;quot;&amp;gt;{{cite journal| author=| title=Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. The Cardiac Arrhythmia Suppression Trial II Investigators. | journal=N Engl J Med | year= 1992 | volume= 327 | issue= 4 | pages= 227-33 | pmid=1377359 | doi=10.1056/NEJM199207233270403 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Suppression of ventricular ectopy after a myocardial infarction reduces the incidence of sudden death, patients in whom ventricular ectopy could be suppressed with encainide, flecainide, or moricizine were randomly assigned to receive either active drug or placebo&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1498 patients,Encainide+Placebo: 857(432 to active drug and 425 to placebo), Flecainide+Placebo: 641 (323 to active drug and 318 to placebo).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 89 patients had died: 59 of arrhythmia (43 receiving drug vs. 16 receiving placebo; P = 0.0004), 22 of nonarrhythmic cardiac causes (17 receiving drug vs. 5 receiving placebo; P = 0.01), and 8 of noncardiac causes (3 receiving drug vs. 5 receiving placebo). Almost all cardiac deaths not due to arrhythmia were attributed to acute myocardial infarction with shock (11 patients receiving drug and 3 receiving placebo) or to chronic congestive heart failure (4 receiving drug and 2 receiving placebo). There were no differences between the patients receiving active drug and those receiving placebo in the incidence of nonlethal disqualifying ventricular tachycardia, proarrhythmia, syncope, need for a permanent pacemaker, congestive heart failure, recurrent myocardial infarction, angina, or need for coronary-artery bypass grafting or angioplasty.&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;CHF-STAT (Congestive heart failure: Survival trial of antiarrhythmic therapy)&amp;lt;ref name=&amp;quot;pmid7539890&amp;quot;&amp;gt;{{cite journal| author=Singh SN, Fletcher RD, Fisher SG, Singh BN, Lewis HD, Deedwania PC et al.| title=Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia. Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure. | journal=N Engl J Med | year= 1995 | volume= 333 | issue= 2 | pages= 77-82 | pmid=7539890 | doi=10.1056/NEJM199507133330201 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 674, Amiodarone: 336, Placebo: 338&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: to determine whether Amiodarone can reduce overall mortality in patients with congestive heart failure and asymptomatic ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%, ≥10 PVCs/hr&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: The rate of sudden death was 15% in the Amiodarone group and 19% in the placebo group in Ischemic Cardiomyopathy group (P=0.43). Reduction in overall mortality among the patients with nonischemic cardiomyopathy who received Amiodarone (P =0.07).&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039; SWORD (The Survival With Oral d-Sotalol trial)&amp;lt;ref name=&amp;quot;pmid8691967&amp;quot;&amp;gt;{{cite journal| author=Waldo AL, Camm AJ, deRuyter H, Friedman PL, MacNeil DJ, Pauls JF et al.| title=Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. The SWORD Investigators. Survival With Oral d-Sotalol. | journal=Lancet | year= 1996 | volume= 348 | issue= 9019 | pages= 7-12 | pmid=8691967 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=8691967  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;:  whether d-sotalol, could reduce all-cause mortality in patients with Left ventricular dysfunction after myocardial infarction .&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 3121, d-Sotalol : 1549, placebo : 1572 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  Mortality : d-sotalol: 78 deaths (5.0%), Placebo: 48 deaths (3.1%) (relative risk 1.65 [95% CI 115–2.36], p=0.006). Presumed arrhythmic deaths (relative risk 1.77 [1.15–2.74], p=0.008). The effect was greater in patients with a left ventricular ejection fraction of 31–40% than in those with lower (≤30%) ejection fractions (relative risk 4.0 vs 1.2, p=0.007).&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&amp;lt;ref name=&amp;quot;pmid8960472&amp;quot;&amp;gt;{{cite journal| author=Moss AJ, Hall WJ, Cannom DS, Daubert JP, Higgins SL, Klein H et al.| title=Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators. | journal=N Engl J Med | year= 1996 | volume= 335 | issue= 26 | pages= 1933-40 | pmid=8960472 | doi=10.1056/NEJM199612263352601 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
6. &#039;&#039;&#039;GESICA (the Gruppo de Estudo de la Sobrevida en la Insuficiencia Cardiaca en Argentina)&amp;lt;ref name=&amp;quot;pmid8989129&amp;quot;&amp;gt;{{cite journal| author=Doval HC, Nul DR, Grancelli HO, Varini SD, Soifer S, Corrado G et al.| title=Nonsustained ventricular tachycardia in severe heart failure. Independent marker of increased mortality due to sudden death. GESICA-GEMA Investigators. | journal=Circulation | year= 1996 | volume= 94 | issue= 12 | pages= 3198-203 | pmid=8989129 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To determine the prognostic value of nonsustained ventricular tachycardia (NSVT) in total mortality in severe congestive heart failure (CHF) and predictive value of NSVT as a marker for sudden death or death due to progressive heart failure. &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 516, NSVT: 173 (33.5%), No NSVT: and 343 (66.5&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality - NSVT: 87(50.3%) No NSVT: (30.9%) (RR = 1.69 (95% confidence interval [CI], 1.27 to 2.24; P&amp;lt;.0002; Cox proportional hazard analysis was 1.62 (95% CI, 1.22 to 2.16; P&amp;lt;.001)). Sudden death – No NSVT: 8.7%, NSVT: 23.7% (RR, 2.77; 95% CI, 1.78 to 4.44; P&amp;lt;.001). Progressive heart failure death – No NSVT: 17.5%, NSVT: 20.8% (P=.22). Couplets prediction of total all-cause mortality: RR, 1.81; 95% CI, 1.22 to 2.66; P&amp;lt;.002 ; sudden death: RR, 3.37; 95% CI, 1.57 to 7.25; P&amp;lt;.0005. Couplets±NSVT prediction of sudden death: RR, 10.1; 95% CI, 1.91 to 52.7; P&amp;lt;.01.&lt;br /&gt;
&lt;br /&gt;
7. &#039;&#039;&#039;EMIAT (The European Myocardial Infarct Amiodarone Trial)&amp;lt;ref name=&amp;quot;pmid9078197&amp;quot;&amp;gt;{{cite journal| author=Julian DG, Camm AJ, Frangin G, Janse MJ, Munoz A, Schwartz PJ et al.| title=Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT. European Myocardial Infarct Amiodarone Trial Investigators. | journal=Lancet | year= 1997 | volume= 349 | issue= 9053 | pages= 667-74 | pmid=9078197 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=9078197  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone effect on reduction of mortality in patients of myocardial infarction with impaired ventricular function, irrespective of whether they had ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1486, Amiodarone : 743, Placebo : 743&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone group, there was a 35% risk reduction (95% CI 0–58, p=0.05) in arrhythmic deaths.&lt;br /&gt;
&lt;br /&gt;
8. &#039;&#039;&#039;CAMIAT (The Cardiac Arrhythmia Suppression Trial)&amp;lt;ref name=&amp;quot;pmid9078198&amp;quot;&amp;gt;{{cite journal| author=Cairns JA, Connolly SJ, Roberts R, Gent M| title=Randomised trial of outcome after myocardial infarction in patients with frequent or repetitive ventricular premature depolarisations: CAMIAT. Canadian Amiodarone Myocardial Infarction Arrhythmia Trial Investigators. | journal=Lancet | year= 1997 | volume= 349 | issue= 9053 | pages= 675-82 | pmid=9078198 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=9078198  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess the effect of amiodarone on the risk of resuscitated ventricular fibrillation or arrhythmic death among survivors of myocardial infarction with frequent or repetitive VPDs (≥10 VPDs per h or ≥1 run of ventricular tachycardia).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 1202, Amiodarone :  606, Placebo: 596&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;:&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Analysis: resuscitated ventricular fibrillation or arrhythmic death – Placebo : 31 (6.0%) Amiodarone : 15 (3.3%) (relative-risk reduction 48.5% [95% CI 4.5 to 72.2], p=0.016). Intention-to-treat analysis: primary outcome events Placebo : 24 (6.9%) Amiodarone : 15 (4.5 (38.2% [95% CI –2.1 to 62.6], p=0.029). The absolute-risk reductions were greatest among patients with congestive heart failure or a history of myocardial infarction.&lt;br /&gt;
&lt;br /&gt;
9. &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&amp;lt;ref name=&amp;quot;pmid10086963&amp;quot;&amp;gt;{{cite journal| author=Bigger JT, Whang W, Rottman JN, Kleiger RE, Gottlieb CD, Namerow PB et al.| title=Mechanisms of death in the CABG Patch trial: a randomized trial of implantable cardiac defibrillator prophylaxis in patients at high risk of death after coronary artery bypass graft surgery. | journal=Circulation | year= 1999 | volume= 99 | issue= 11 | pages= 1416-21 | pmid=10086963 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
10. &#039;&#039;&#039;MUSTT (the Multicenter Unsustained Tachycardia Trial)&amp;lt;ref name=&amp;quot;pmid10601507&amp;quot;&amp;gt;{{cite journal| author=Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EN, Hafley G| title=A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators. | journal=N Engl J Med | year= 1999 | volume= 341 | issue= 25 | pages= 1882-90 | pmid=10601507 | doi=10.1056/NEJM199912163412503 | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Electrophysiologically guided antiarrhythmic therapy would reduce the risk of sudden death among patients with coronary artery disease, a left ventricular ejection fraction of 40 percent or less, and asymptomatic, unsustained ventricular tachycardia&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: 704 patients who underwent randomization, 351 were assigned to receive electrophysiologically guided therapy and 353 were assigned to receive no antiarrhythmic therapy.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: LVEF &amp;lt;40% + NSVT&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study:  Cardiac Arrest or Death from Arrhythmia - EP guided therapy = 25% no antiarrhythmic therapy = 32% (RR=0.73, CI=0.53-0.99). Cardiac arrest or death from arrhythmia - Treatment with Defibrillators vs w/o Defibrillator Treatment (RR=0.24; CI=0.13-0.45; P&amp;lt;0.001). &lt;br /&gt;
&lt;br /&gt;
11. &#039;&#039;&#039;MADIT II (Multicenter Automatic Defibrillator Implantation Trial - II)&amp;lt;ref name=&amp;quot;pmid11907286&amp;quot;&amp;gt;{{cite journal| author=Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS et al.| title=Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. | journal=N Engl J Med | year= 2002 | volume= 346 | issue= 12 | pages= 877-83 | pmid=11907286 | doi=10.1056/NEJMoa013474 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=11907286  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=12418821 Review in: ACP J Club. 2002 Nov-Dec;137(3):81] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To evaluate the effect of an implantable defibrillator on survival in patients with reduced left ventricular function after myocardial infarction are at risk for life threatening ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1232, ICD: 742, Conventional Medical Therapy: 490 patients&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤30% &amp;gt;10 PVCs/hr or couplets&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality – Conventional Medical Therapy: 19.8%, ICD: 14.2%(HR 0.69 (95 CI= 0.51-0.93, P=0.016).&lt;br /&gt;
&lt;br /&gt;
12. &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&amp;lt;ref name=&amp;quot;pmid12767651&amp;quot;&amp;gt;{{cite journal| author=Strickberger SA, Hummel JD, Bartlett TG, Frumin HI, Schuger CD, Beau SL et al.| title=Amiodarone versus implantable cardioverter-defibrillator:randomized trial in patients with nonischemic dilated cardiomyopathy and asymptomatic nonsustained ventricular tachycardia--AMIOVIRT. | journal=J Am Coll Cardiol | year= 2003 | volume= 41 | issue= 10 | pages= 1707-12 | pmid=12767651 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=12767651  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
13. &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&amp;lt;ref name=&amp;quot;pmid15152060&amp;quot;&amp;gt;{{cite journal| author=Kadish A, Dyer A, Daubert JP, Quigg R, Estes NA, Anderson KP et al.| title=Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. | journal=N Engl J Med | year= 2004 | volume= 350 | issue= 21 | pages= 2151-8 | pmid=15152060 | doi=10.1056/NEJMoa033088 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15152060  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15518445 Review in: ACP J Club. 2004 Nov-Dec;141(3):61] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
14. &#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&amp;lt;ref name=&amp;quot;pmid15590950&amp;quot;&amp;gt;{{cite journal| author=Hohnloser SH, Kuck KH, Dorian P, Roberts RS, Hampton JR, Hatala R et al.| title=Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. | journal=N Engl J Med | year= 2004 | volume= 351 | issue= 24 | pages= 2481-8 | pmid=15590950 | doi=10.1056/NEJMoa041489 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15590950  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15862057 Review in: ACP J Club. 2005 May-Jun;142(3):58] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
15. &#039;&#039;&#039;COMPANION (The Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure trial )&amp;lt;ref name=&amp;quot;pmid15152059&amp;quot;&amp;gt;{{cite journal| author=Bristow MR, Saxon LA, Boehmer J, Krueger S, Kass DA, De Marco T et al.| title=Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. | journal=N Engl J Med | year= 2004 | volume= 350 | issue= 21 | pages= 2140-50 | pmid=15152059 | doi=10.1056/NEJMoa032423 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15152059  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15518444 Review in: ACP J Club. 2004 Nov-Dec;141(3):60] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Prophylactic cardiac-resynchronization therapy in the form of biventricular stimulation with a pacemaker with or without a defibrillator would reduce the risk of death and hospitalization among patients with advanced chronic heart failure and intraventricular conduction delays.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1520, Optimal Pharmacologic Therapy: 308, Cardiac- Resynchronization Therapy:  Pacemaker=617, Pacemaker– Defibrillator=595&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: Ischemic or nonischemic CM NYHA Class III-IV QRS ≥120 msec&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Pacemaker group - Primary end point mortality reduction (hazard ratio, 0.81; P=0.014), Pacemaker–defibrillator group (hazard ratio, 0.80; P=0.01). Primary end point mortality reduction: 34% - Pacemaker group (P&amp;lt;0.002), 40% - Pacemaker–Defibrillator group (P&amp;lt;0.001). Secondary end point mortality reduction: 24% - Pacemaker group (P=0.059), 36% - Pacemaker–Defibrillator group (P=0.003). &lt;br /&gt;
&lt;br /&gt;
16. &#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&amp;lt;ref name=&amp;quot;pmid15659722&amp;quot;&amp;gt;{{cite journal| author=Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, Boineau R et al.| title=Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. | journal=N Engl J Med | year= 2005 | volume= 352 | issue= 3 | pages= 225-37 | pmid=15659722 | doi=10.1056/NEJMoa043399 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15659722  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15989294 Review in: ACP J Club. 2005 Jul-Aug;143(1):6] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
17. &#039;&#039;&#039;MADIT-CRT(Multicenter automatic defibrillator implantation trial-cardiac resynchronization therapy)&#039;&#039;&#039;&amp;lt;ref name=&amp;quot;pmid19723701&amp;quot;&amp;gt;{{cite journal| author=Moss AJ, Hall WJ, Cannom DS, Klein H, Brown MW, Daubert JP et al.| title=Cardiac-resynchronization therapy for the prevention of heart-failure events. | journal=N Engl J Med | year= 2009 | volume= 361 | issue= 14 | pages= 1329-38 | pmid=19723701 | doi=10.1056/NEJMoa0906431 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=19723701  }} &amp;lt;/ref&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To determine whether cardiac-resynchronization therapy (CRT) with biventricular pacing would reduce the risk of death or heart-failure events in patients with mild cardiac symptoms, a reduced ejection fraction, and a wide QRS complex.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 1820, CRT + ICD = 1089, ICD alone = 731&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;30%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy study: CRT-ICD primary end point mortality = 17.2%, ICD-only group = 25.3% HR=0.66; 95% CI = 0.52-0.84, p=0.001.&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=620326</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=620326"/>
		<updated>2012-01-13T00:05:46Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: /* Trials of primary prevention of sudden cardiac death */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;CASCADE(The Cardiac Arrest in Seatle Conventional Versus Amiodarone Drug Evaluation study)&amp;lt;ref name=&amp;quot;pmid8237833&amp;quot;&amp;gt;{{cite journal| author=Greene HL| title=The CASCADE Study: randomized antiarrhythmic drug therapy in survivors of cardiac arrest in Seattle. CASCADE Investigators. | journal=Am J Cardiol | year= 1993 | volume= 72 | issue= 16 | pages= 70F-74F | pmid=8237833 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone vs conventional therapy in patients with/without AICD&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 228 Amiodarone: 113 conventional antiarrhythmic drugs: 115(quinidine (n=33), procainamide (n = 26), combination therapy (n = 17), flecainide (n = 12). AICD: 105 (Amiodarone: 53, Conventional therapy: 52)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 13% more survival in patient population at the primary end point (total cardiac mortality, resuscitated cardiac arrest due to ventricular fibrillation, and syncopal Implanted defibrillator shocks) at the end of 6 years. (p=0.007).  With AICD 16% survival more at the primary end point( shocks preceded by complete syncope)(p=0.032) conclusively showing superiority of Amidarone over convetional therapy in secondary prevention.&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039; ESVEM (Electrophysiologic Study Versus Electrocardiographic Monitoring for Selection of Antiarrhythmic Therapy of Ventricular Tachyarrhythmias)&amp;lt;ref name=&amp;quot;pmid8332149&amp;quot;&amp;gt;{{cite journal| author=Mason JW| title=A comparison of electrophysiologic testing with Holter monitoring to predict antiarrhythmic-drug efficacy for ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. | journal=N Engl J Med | year= 1993 | volume= 329 | issue= 7 | pages= 445-51 | pmid=8332149 | doi=10.1056/NEJM199308123290701 | pmc= | url= }} &amp;lt;/ref&amp;gt;&amp;lt;ref name=&amp;quot;pmid8332150&amp;quot;&amp;gt;{{cite journal| author=Mason JW| title=A comparison of seven antiarrhythmic drugs in patients with ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. | journal=N Engl J Med | year= 1993 | volume= 329 | issue= 7 | pages= 452-8 | pmid=8332150 | doi=10.1056/NEJM199308123290702 | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: EP testing and Holter monitor of 7 antiarrhythmics (imipramine, mexiletine, procainamide, quinidine, sotalol, pirmenol, propafenone)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  486 patients were randomized and 296 patients were eventually followed up.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 33% in all 296 and 34% in Sotalol group&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  No difference between Holter- and EP-guided groups. Sotalol group had lowest recurrence rate of VT (risk ratio, 0.43; 95 percent confidence interval, 0.29 to 0.62; p&amp;lt;0.001), arrhythmic death (risk ratio, 0.50; 95 percent confidence interval, 0.26 to 0.96; P = 0.04), total death (risk ratio, 0.50; 95 percent confidence interval, 0.30 to 0.80; P = 0.004).&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&amp;lt;ref name=&amp;quot;pmid9411221&amp;quot;&amp;gt;{{cite journal| author=| title=A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. The Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators. | journal=N Engl J Med | year= 1997 | volume= 337 | issue= 22 | pages= 1576-83 | pmid=9411221 | doi=10.1056/NEJM199711273372202 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&amp;lt;ref name=&amp;quot;pmid10725290&amp;quot;&amp;gt;{{cite journal| author=Connolly SJ, Gent M, Roberts RS, Dorian P, Roy D, Sheldon RS et al.| title=Canadian implantable defibrillator study (CIDS) : a randomized trial of the implantable cardioverter defibrillator against amiodarone. | journal=Circulation | year= 2000 | volume= 101 | issue= 11 | pages= 1297-302 | pmid=10725290 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&amp;lt;ref name=&amp;quot;pmid10942742&amp;quot;&amp;gt;{{cite journal| author=Kuck KH, Cappato R, Siebels J, Rüppel R| title=Randomized comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from cardiac arrest : the Cardiac Arrest Study Hamburg (CASH). | journal=Circulation | year= 2000 | volume= 102 | issue= 7 | pages= 748-54 | pmid=10942742 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039; BHAT  ( β-Blocker Heart Attack Trial)&amp;lt;ref name=&amp;quot;pmid7038157&amp;quot;&amp;gt;{{cite journal| author=| title=A randomized trial of propranolol in patients with acute myocardial infarction. I. Mortality results. | journal=JAMA | year= 1982 | volume= 247 | issue= 12 | pages= 1707-14 | pmid=7038157 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039; : multicenter, randomized, double-blind, and placebo-controlled trial designed to test whether the regular administration of propranolol hydrochloride to men and women who had experienced at least one myocardial infarction would result in a significant reduction in total mortality during a two- to four-year period.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 3837, Propanolol: 1916, Placebo: 1921 persons, five to 21 days after the infarction.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Total mortality during the average 25-month follow-up period was 7.2% in the propranolol group and 9.8% in the placebo group. Arteriosclerotic heart disease (ASHD) mortality was 6.2% in the propranolol group and 8.5% in the placebo group. &lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CAST (The Cardiac Arrhythmia Suppression Trial)&amp;lt;ref name=&amp;quot;pmid1900101&amp;quot;&amp;gt;{{cite journal| author=Echt DS, Liebson PR, Mitchell LB, Peters RW, Obias-Manno D, Barker AH et al.| title=Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. | journal=N Engl J Med | year= 1991 | volume= 324 | issue= 12 | pages= 781-8 | pmid=1900101 | doi=10.1056/NEJM199103213241201 | pmc= | url= }} &amp;lt;/ref&amp;gt;&amp;lt;ref name=&amp;quot;pmid1377359&amp;quot;&amp;gt;{{cite journal| author=| title=Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. The Cardiac Arrhythmia Suppression Trial II Investigators. | journal=N Engl J Med | year= 1992 | volume= 327 | issue= 4 | pages= 227-33 | pmid=1377359 | doi=10.1056/NEJM199207233270403 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Suppression of ventricular ectopy after a myocardial infarction reduces the incidence of sudden death, patients in whom ventricular ectopy could be suppressed with encainide, flecainide, or moricizine were randomly assigned to receive either active drug or placebo&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1498 patients,Encainide+Placebo: 857(432 to active drug and 425 to placebo), Flecainide+Placebo: 641 (323 to active drug and 318 to placebo).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 89 patients had died: 59 of arrhythmia (43 receiving drug vs. 16 receiving placebo; P = 0.0004), 22 of nonarrhythmic cardiac causes (17 receiving drug vs. 5 receiving placebo; P = 0.01), and 8 of noncardiac causes (3 receiving drug vs. 5 receiving placebo). Almost all cardiac deaths not due to arrhythmia were attributed to acute myocardial infarction with shock (11 patients receiving drug and 3 receiving placebo) or to chronic congestive heart failure (4 receiving drug and 2 receiving placebo). There were no differences between the patients receiving active drug and those receiving placebo in the incidence of nonlethal disqualifying ventricular tachycardia, proarrhythmia, syncope, need for a permanent pacemaker, congestive heart failure, recurrent myocardial infarction, angina, or need for coronary-artery bypass grafting or angioplasty.&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;CHF-STAT (Congestive heart failure: Survival trial of antiarrhythmic therapy)&amp;lt;ref name=&amp;quot;pmid7539890&amp;quot;&amp;gt;{{cite journal| author=Singh SN, Fletcher RD, Fisher SG, Singh BN, Lewis HD, Deedwania PC et al.| title=Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia. Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure. | journal=N Engl J Med | year= 1995 | volume= 333 | issue= 2 | pages= 77-82 | pmid=7539890 | doi=10.1056/NEJM199507133330201 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 674, Amiodarone: 336, Placebo: 338&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: to determine whether Amiodarone can reduce overall mortality in patients with congestive heart failure and asymptomatic ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%, ≥10 PVCs/hr&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: The rate of sudden death was 15% in the Amiodarone group and 19% in the placebo group in Ischemic Cardiomyopathy group (P=0.43). Reduction in overall mortality among the patients with nonischemic cardiomyopathy who received Amiodarone (P =0.07).&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039; SWORD (The Survival With Oral d-Sotalol trial)&amp;lt;ref name=&amp;quot;pmid8691967&amp;quot;&amp;gt;{{cite journal| author=Waldo AL, Camm AJ, deRuyter H, Friedman PL, MacNeil DJ, Pauls JF et al.| title=Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. The SWORD Investigators. Survival With Oral d-Sotalol. | journal=Lancet | year= 1996 | volume= 348 | issue= 9019 | pages= 7-12 | pmid=8691967 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=8691967  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;:  whether d-sotalol, could reduce all-cause mortality in patients with Left ventricular dysfunction after myocardial infarction .&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 3121, d-Sotalol : 1549, placebo : 1572 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  Mortality : d-sotalol: 78 deaths (5.0%), Placebo: 48 deaths (3.1%) (relative risk 1.65 [95% CI 115–2.36], p=0.006). Presumed arrhythmic deaths (relative risk 1.77 [1.15–2.74], p=0.008). The effect was greater in patients with a left ventricular ejection fraction of 31–40% than in those with lower (≤30%) ejection fractions (relative risk 4.0 vs 1.2, p=0.007).&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&amp;lt;ref name=&amp;quot;pmid8960472&amp;quot;&amp;gt;{{cite journal| author=Moss AJ, Hall WJ, Cannom DS, Daubert JP, Higgins SL, Klein H et al.| title=Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators. | journal=N Engl J Med | year= 1996 | volume= 335 | issue= 26 | pages= 1933-40 | pmid=8960472 | doi=10.1056/NEJM199612263352601 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
6. &#039;&#039;&#039;GESICA (the Gruppo de Estudo de la Sobrevida en la Insuficiencia Cardiaca en Argentina)&amp;lt;ref name=&amp;quot;pmid8989129&amp;quot;&amp;gt;{{cite journal| author=Doval HC, Nul DR, Grancelli HO, Varini SD, Soifer S, Corrado G et al.| title=Nonsustained ventricular tachycardia in severe heart failure. Independent marker of increased mortality due to sudden death. GESICA-GEMA Investigators. | journal=Circulation | year= 1996 | volume= 94 | issue= 12 | pages= 3198-203 | pmid=8989129 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To determine the prognostic value of nonsustained ventricular tachycardia (NSVT) in total mortality in severe congestive heart failure (CHF) and predictive value of NSVT as a marker for sudden death or death due to progressive heart failure. &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 516, NSVT: 173 (33.5%), No NSVT: and 343 (66.5&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality - NSVT: 87(50.3%) No NSVT: (30.9%) (RR = 1.69 (95% confidence interval [CI], 1.27 to 2.24; P&amp;lt;.0002; Cox proportional hazard analysis was 1.62 (95% CI, 1.22 to 2.16; P&amp;lt;.001)). Sudden death – No NSVT: 8.7%, NSVT: 23.7% (RR, 2.77; 95% CI, 1.78 to 4.44; P&amp;lt;.001). Progressive heart failure death – No NSVT: 17.5%, NSVT: 20.8% (P=.22). Couplets prediction of total all-cause mortality: RR, 1.81; 95% CI, 1.22 to 2.66; P&amp;lt;.002 ; sudden death: RR, 3.37; 95% CI, 1.57 to 7.25; P&amp;lt;.0005. Couplets±NSVT prediction of sudden death: RR, 10.1; 95% CI, 1.91 to 52.7; P&amp;lt;.01.&lt;br /&gt;
&lt;br /&gt;
7. &#039;&#039;&#039;EMIAT (The European Myocardial Infarct Amiodarone Trial)&amp;lt;ref name=&amp;quot;pmid9078197&amp;quot;&amp;gt;{{cite journal| author=Julian DG, Camm AJ, Frangin G, Janse MJ, Munoz A, Schwartz PJ et al.| title=Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT. European Myocardial Infarct Amiodarone Trial Investigators. | journal=Lancet | year= 1997 | volume= 349 | issue= 9053 | pages= 667-74 | pmid=9078197 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=9078197  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone effect on reduction of mortality in patients of myocardial infarction with impaired ventricular function, irrespective of whether they had ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1486, Amiodarone : 743, Placebo : 743&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone group, there was a 35% risk reduction (95% CI 0–58, p=0.05) in arrhythmic deaths.&lt;br /&gt;
&lt;br /&gt;
8. &#039;&#039;&#039;CAMIAT (The Cardiac Arrhythmia Suppression Trial)&amp;lt;ref name=&amp;quot;pmid9078198&amp;quot;&amp;gt;{{cite journal| author=Cairns JA, Connolly SJ, Roberts R, Gent M| title=Randomised trial of outcome after myocardial infarction in patients with frequent or repetitive ventricular premature depolarisations: CAMIAT. Canadian Amiodarone Myocardial Infarction Arrhythmia Trial Investigators. | journal=Lancet | year= 1997 | volume= 349 | issue= 9053 | pages= 675-82 | pmid=9078198 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=9078198  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess the effect of amiodarone on the risk of resuscitated ventricular fibrillation or arrhythmic death among survivors of myocardial infarction with frequent or repetitive VPDs (≥10 VPDs per h or ≥1 run of ventricular tachycardia).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 1202, Amiodarone :  606, Placebo: 596&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;:&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Analysis: resuscitated ventricular fibrillation or arrhythmic death – Placebo : 31 (6.0%) Amiodarone : 15 (3.3%) (relative-risk reduction 48.5% [95% CI 4.5 to 72.2], p=0.016). Intention-to-treat analysis: primary outcome events Placebo : 24 (6.9%) Amiodarone : 15 (4.5 (38.2% [95% CI –2.1 to 62.6], p=0.029). The absolute-risk reductions were greatest among patients with congestive heart failure or a history of myocardial infarction.&lt;br /&gt;
&lt;br /&gt;
9. &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&amp;lt;ref name=&amp;quot;pmid10086963&amp;quot;&amp;gt;{{cite journal| author=Bigger JT, Whang W, Rottman JN, Kleiger RE, Gottlieb CD, Namerow PB et al.| title=Mechanisms of death in the CABG Patch trial: a randomized trial of implantable cardiac defibrillator prophylaxis in patients at high risk of death after coronary artery bypass graft surgery. | journal=Circulation | year= 1999 | volume= 99 | issue= 11 | pages= 1416-21 | pmid=10086963 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
10. &#039;&#039;&#039;MUSTT (the Multicenter Unsustained Tachycardia Trial)&amp;lt;ref name=&amp;quot;pmid10601507&amp;quot;&amp;gt;{{cite journal| author=Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EN, Hafley G| title=A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators. | journal=N Engl J Med | year= 1999 | volume= 341 | issue= 25 | pages= 1882-90 | pmid=10601507 | doi=10.1056/NEJM199912163412503 | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Electrophysiologically guided antiarrhythmic therapy would reduce the risk of sudden death among patients with coronary artery disease, a left ventricular ejection fraction of 40 percent or less, and asymptomatic, unsustained ventricular tachycardia&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: 704 patients who underwent randomization, 351 were assigned to receive electrophysiologically guided therapy and 353 were assigned to receive no antiarrhythmic therapy.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: LVEF &amp;lt;40% + NSVT&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study:  Cardiac Arrest or Death from Arrhythmia - EP guided therapy = 25% no antiarrhythmic therapy = 32% (RR=0.73, CI=0.53-0.99). Cardiac arrest or death from arrhythmia - Treatment with Defibrillators vs w/o Defibrillator Treatment (RR=0.24; CI=0.13-0.45; P&amp;lt;0.001). &lt;br /&gt;
&lt;br /&gt;
11. &#039;&#039;&#039;MADIT II (Multicenter Automatic Defibrillator Implantation Trial - II)&amp;lt;ref name=&amp;quot;pmid11907286&amp;quot;&amp;gt;{{cite journal| author=Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS et al.| title=Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. | journal=N Engl J Med | year= 2002 | volume= 346 | issue= 12 | pages= 877-83 | pmid=11907286 | doi=10.1056/NEJMoa013474 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=11907286  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=12418821 Review in: ACP J Club. 2002 Nov-Dec;137(3):81] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To evaluate the effect of an implantable defibrillator on survival in patients with reduced left ventricular function after myocardial infarction are at risk for life threatening ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1232, ICD: 742, Conventional Medical Therapy: 490 patients&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤30% &amp;gt;10 PVCs/hr or couplets&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality – Conventional Medical Therapy: 19.8%, ICD: 14.2%(HR 0.69 (95 CI= 0.51-0.93, P=0.016).&lt;br /&gt;
&lt;br /&gt;
12. &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&amp;lt;ref name=&amp;quot;pmid12767651&amp;quot;&amp;gt;{{cite journal| author=Strickberger SA, Hummel JD, Bartlett TG, Frumin HI, Schuger CD, Beau SL et al.| title=Amiodarone versus implantable cardioverter-defibrillator:randomized trial in patients with nonischemic dilated cardiomyopathy and asymptomatic nonsustained ventricular tachycardia--AMIOVIRT. | journal=J Am Coll Cardiol | year= 2003 | volume= 41 | issue= 10 | pages= 1707-12 | pmid=12767651 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=12767651  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
13. &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&amp;lt;ref name=&amp;quot;pmid15152060&amp;quot;&amp;gt;{{cite journal| author=Kadish A, Dyer A, Daubert JP, Quigg R, Estes NA, Anderson KP et al.| title=Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. | journal=N Engl J Med | year= 2004 | volume= 350 | issue= 21 | pages= 2151-8 | pmid=15152060 | doi=10.1056/NEJMoa033088 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15152060  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15518445 Review in: ACP J Club. 2004 Nov-Dec;141(3):61] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
14. &#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&amp;lt;ref name=&amp;quot;pmid15590950&amp;quot;&amp;gt;{{cite journal| author=Hohnloser SH, Kuck KH, Dorian P, Roberts RS, Hampton JR, Hatala R et al.| title=Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. | journal=N Engl J Med | year= 2004 | volume= 351 | issue= 24 | pages= 2481-8 | pmid=15590950 | doi=10.1056/NEJMoa041489 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15590950  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15862057 Review in: ACP J Club. 2005 May-Jun;142(3):58] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
15. &#039;&#039;&#039;COMPANION (The Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure trial )&amp;lt;ref name=&amp;quot;pmid15152059&amp;quot;&amp;gt;{{cite journal| author=Bristow MR, Saxon LA, Boehmer J, Krueger S, Kass DA, De Marco T et al.| title=Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. | journal=N Engl J Med | year= 2004 | volume= 350 | issue= 21 | pages= 2140-50 | pmid=15152059 | doi=10.1056/NEJMoa032423 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15152059  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15518444 Review in: ACP J Club. 2004 Nov-Dec;141(3):60] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Prophylactic cardiac-resynchronization therapy in the form of biventricular stimulation with a pacemaker with or without a defibrillator would reduce the risk of death and hospitalization among patients with advanced chronic heart failure and intraventricular conduction delays.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1520, Optimal Pharmacologic Therapy: 308, Cardiac- Resynchronization Therapy:  Pacemaker=617, Pacemaker– Defibrillator=595&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: Ischemic or nonischemic CM NYHA Class III-IV QRS ≥120 msec&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Pacemaker group - Primary end point mortality reduction (hazard ratio, 0.81; P=0.014), Pacemaker–defibrillator group (hazard ratio, 0.80; P=0.01). Primary end point mortality reduction: 34% - Pacemaker group (P&amp;lt;0.002), 40% - Pacemaker–Defibrillator group (P&amp;lt;0.001). Secondary end point mortality reduction: 24% - Pacemaker group (P=0.059), 36% - Pacemaker–Defibrillator group (P=0.003). &lt;br /&gt;
&lt;br /&gt;
16. &#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&amp;lt;ref name=&amp;quot;pmid15659722&amp;quot;&amp;gt;{{cite journal| author=Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, Boineau R et al.| title=Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. | journal=N Engl J Med | year= 2005 | volume= 352 | issue= 3 | pages= 225-37 | pmid=15659722 | doi=10.1056/NEJMoa043399 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15659722  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15989294 Review in: ACP J Club. 2005 Jul-Aug;143(1):6] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
17. &#039;&#039;&#039;MADIT-CRT(Multicenter automatic defibrillator implantation trial-cardiac resynchronization therapy)&#039;&#039;&#039;&amp;lt;ref name=&amp;quot;pmid19723701&amp;quot;&amp;gt;{{cite journal| author=Moss AJ, Hall WJ, Cannom DS, Klein H, Brown MW, Daubert JP et al.| title=Cardiac-resynchronization therapy for the prevention of heart-failure events. | journal=N Engl J Med | year= 2009 | volume= 361 | issue= 14 | pages= 1329-38 | pmid=19723701 | doi=10.1056/NEJMoa0906431 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=19723701  }} &amp;lt;/ref&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To determine whether cardiac-resynchronization therapy (CRT) with biventricular pacing would reduce the risk of death or heart-failure events in patients with mild cardiac symptoms, a reduced ejection fraction, and a wide QRS complex.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 1820, CRT + ICD = 1089, ICD alone = 731&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;30%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy study: CRT-ICD primary end point mortality = 17.2%, ICD-only group = 25.3% HR=0.66; 95% CI = 0.52-0.84, p=0.001.&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
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{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=620325</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=620325"/>
		<updated>2012-01-13T00:02:08Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;CASCADE(The Cardiac Arrest in Seatle Conventional Versus Amiodarone Drug Evaluation study)&amp;lt;ref name=&amp;quot;pmid8237833&amp;quot;&amp;gt;{{cite journal| author=Greene HL| title=The CASCADE Study: randomized antiarrhythmic drug therapy in survivors of cardiac arrest in Seattle. CASCADE Investigators. | journal=Am J Cardiol | year= 1993 | volume= 72 | issue= 16 | pages= 70F-74F | pmid=8237833 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone vs conventional therapy in patients with/without AICD&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 228 Amiodarone: 113 conventional antiarrhythmic drugs: 115(quinidine (n=33), procainamide (n = 26), combination therapy (n = 17), flecainide (n = 12). AICD: 105 (Amiodarone: 53, Conventional therapy: 52)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 13% more survival in patient population at the primary end point (total cardiac mortality, resuscitated cardiac arrest due to ventricular fibrillation, and syncopal Implanted defibrillator shocks) at the end of 6 years. (p=0.007).  With AICD 16% survival more at the primary end point( shocks preceded by complete syncope)(p=0.032) conclusively showing superiority of Amidarone over convetional therapy in secondary prevention.&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039; ESVEM (Electrophysiologic Study Versus Electrocardiographic Monitoring for Selection of Antiarrhythmic Therapy of Ventricular Tachyarrhythmias)&amp;lt;ref name=&amp;quot;pmid8332149&amp;quot;&amp;gt;{{cite journal| author=Mason JW| title=A comparison of electrophysiologic testing with Holter monitoring to predict antiarrhythmic-drug efficacy for ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. | journal=N Engl J Med | year= 1993 | volume= 329 | issue= 7 | pages= 445-51 | pmid=8332149 | doi=10.1056/NEJM199308123290701 | pmc= | url= }} &amp;lt;/ref&amp;gt;&amp;lt;ref name=&amp;quot;pmid8332150&amp;quot;&amp;gt;{{cite journal| author=Mason JW| title=A comparison of seven antiarrhythmic drugs in patients with ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. | journal=N Engl J Med | year= 1993 | volume= 329 | issue= 7 | pages= 452-8 | pmid=8332150 | doi=10.1056/NEJM199308123290702 | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: EP testing and Holter monitor of 7 antiarrhythmics (imipramine, mexiletine, procainamide, quinidine, sotalol, pirmenol, propafenone)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  486 patients were randomized and 296 patients were eventually followed up.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 33% in all 296 and 34% in Sotalol group&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  No difference between Holter- and EP-guided groups. Sotalol group had lowest recurrence rate of VT (risk ratio, 0.43; 95 percent confidence interval, 0.29 to 0.62; p&amp;lt;0.001), arrhythmic death (risk ratio, 0.50; 95 percent confidence interval, 0.26 to 0.96; P = 0.04), total death (risk ratio, 0.50; 95 percent confidence interval, 0.30 to 0.80; P = 0.004).&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&amp;lt;ref name=&amp;quot;pmid9411221&amp;quot;&amp;gt;{{cite journal| author=| title=A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. The Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators. | journal=N Engl J Med | year= 1997 | volume= 337 | issue= 22 | pages= 1576-83 | pmid=9411221 | doi=10.1056/NEJM199711273372202 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&amp;lt;ref name=&amp;quot;pmid10725290&amp;quot;&amp;gt;{{cite journal| author=Connolly SJ, Gent M, Roberts RS, Dorian P, Roy D, Sheldon RS et al.| title=Canadian implantable defibrillator study (CIDS) : a randomized trial of the implantable cardioverter defibrillator against amiodarone. | journal=Circulation | year= 2000 | volume= 101 | issue= 11 | pages= 1297-302 | pmid=10725290 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&amp;lt;ref name=&amp;quot;pmid10942742&amp;quot;&amp;gt;{{cite journal| author=Kuck KH, Cappato R, Siebels J, Rüppel R| title=Randomized comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from cardiac arrest : the Cardiac Arrest Study Hamburg (CASH). | journal=Circulation | year= 2000 | volume= 102 | issue= 7 | pages= 748-54 | pmid=10942742 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039; BHAT  ( β-Blocker Heart Attack Trial)&amp;lt;ref name=&amp;quot;pmid7038157&amp;quot;&amp;gt;{{cite journal| author=| title=A randomized trial of propranolol in patients with acute myocardial infarction. I. Mortality results. | journal=JAMA | year= 1982 | volume= 247 | issue= 12 | pages= 1707-14 | pmid=7038157 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039; : multicenter, randomized, double-blind, and placebo-controlled trial designed to test whether the regular administration of propranolol hydrochloride to men and women who had experienced at least one myocardial infarction would result in a significant reduction in total mortality during a two- to four-year period.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 3837, Propanolol: 1916, Placebo: 1921 persons, five to 21 days after the infarction.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Total mortality during the average 25-month follow-up period was 7.2% in the propranolol group and 9.8% in the placebo group. Arteriosclerotic heart disease (ASHD) mortality was 6.2% in the propranolol group and 8.5% in the placebo group. &lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CAST (The Cardiac Arrhythmia Suppression Trial)&amp;lt;ref name=&amp;quot;pmid1900101&amp;quot;&amp;gt;{{cite journal| author=Echt DS, Liebson PR, Mitchell LB, Peters RW, Obias-Manno D, Barker AH et al.| title=Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. | journal=N Engl J Med | year= 1991 | volume= 324 | issue= 12 | pages= 781-8 | pmid=1900101 | doi=10.1056/NEJM199103213241201 | pmc= | url= }} &amp;lt;/ref&amp;gt;&amp;lt;ref name=&amp;quot;pmid1377359&amp;quot;&amp;gt;{{cite journal| author=| title=Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. The Cardiac Arrhythmia Suppression Trial II Investigators. | journal=N Engl J Med | year= 1992 | volume= 327 | issue= 4 | pages= 227-33 | pmid=1377359 | doi=10.1056/NEJM199207233270403 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Suppression of ventricular ectopy after a myocardial infarction reduces the incidence of sudden death, patients in whom ventricular ectopy could be suppressed with encainide, flecainide, or moricizine were randomly assigned to receive either active drug or placebo&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1498 patients,Encainide+Placebo: 857(432 to active drug and 425 to placebo), Flecainide+Placebo: 641 (323 to active drug and 318 to placebo).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 89 patients had died: 59 of arrhythmia (43 receiving drug vs. 16 receiving placebo; P = 0.0004), 22 of nonarrhythmic cardiac causes (17 receiving drug vs. 5 receiving placebo; P = 0.01), and 8 of noncardiac causes (3 receiving drug vs. 5 receiving placebo). Almost all cardiac deaths not due to arrhythmia were attributed to acute myocardial infarction with shock (11 patients receiving drug and 3 receiving placebo) or to chronic congestive heart failure (4 receiving drug and 2 receiving placebo). There were no differences between the patients receiving active drug and those receiving placebo in the incidence of nonlethal disqualifying ventricular tachycardia, proarrhythmia, syncope, need for a permanent pacemaker, congestive heart failure, recurrent myocardial infarction, angina, or need for coronary-artery bypass grafting or angioplasty.&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;CHF-STAT (Congestive heart failure: Survival trial of antiarrhythmic therapy)&amp;lt;ref name=&amp;quot;pmid7539890&amp;quot;&amp;gt;{{cite journal| author=Singh SN, Fletcher RD, Fisher SG, Singh BN, Lewis HD, Deedwania PC et al.| title=Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia. Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure. | journal=N Engl J Med | year= 1995 | volume= 333 | issue= 2 | pages= 77-82 | pmid=7539890 | doi=10.1056/NEJM199507133330201 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 674, Amiodarone: 336, Placebo: 338&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: to determine whether Amiodarone can reduce overall mortality in patients with congestive heart failure and asymptomatic ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%, ≥10 PVCs/hr&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: The rate of sudden death was 15% in the Amiodarone group and 19% in the placebo group in Ischemic Cardiomyopathy group (P=0.43). Reduction in overall mortality among the patients with nonischemic cardiomyopathy who received Amiodarone (P =0.07).&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039; SWORD (The Survival With Oral d-Sotalol trial)&amp;lt;ref name=&amp;quot;pmid8691967&amp;quot;&amp;gt;{{cite journal| author=Waldo AL, Camm AJ, deRuyter H, Friedman PL, MacNeil DJ, Pauls JF et al.| title=Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. The SWORD Investigators. Survival With Oral d-Sotalol. | journal=Lancet | year= 1996 | volume= 348 | issue= 9019 | pages= 7-12 | pmid=8691967 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=8691967  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;:  whether d-sotalol, could reduce all-cause mortality in patients with Left ventricular dysfunction after myocardial infarction .&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 3121, d-Sotalol : 1549, placebo : 1572 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  Mortality : d-sotalol: 78 deaths (5.0%), Placebo: 48 deaths (3.1%) (relative risk 1.65 [95% CI 115–2.36], p=0.006). Presumed arrhythmic deaths (relative risk 1.77 [1.15–2.74], p=0.008). The effect was greater in patients with a left ventricular ejection fraction of 31–40% than in those with lower (≤30%) ejection fractions (relative risk 4.0 vs 1.2, p=0.007).&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&amp;lt;ref name=&amp;quot;pmid8960472&amp;quot;&amp;gt;{{cite journal| author=Moss AJ, Hall WJ, Cannom DS, Daubert JP, Higgins SL, Klein H et al.| title=Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators. | journal=N Engl J Med | year= 1996 | volume= 335 | issue= 26 | pages= 1933-40 | pmid=8960472 | doi=10.1056/NEJM199612263352601 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
6. &#039;&#039;&#039;GESICA (the Gruppo de Estudo de la Sobrevida en la Insuficiencia Cardiaca en Argentina)&amp;lt;ref name=&amp;quot;pmid8989129&amp;quot;&amp;gt;{{cite journal| author=Doval HC, Nul DR, Grancelli HO, Varini SD, Soifer S, Corrado G et al.| title=Nonsustained ventricular tachycardia in severe heart failure. Independent marker of increased mortality due to sudden death. GESICA-GEMA Investigators. | journal=Circulation | year= 1996 | volume= 94 | issue= 12 | pages= 3198-203 | pmid=8989129 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To determine the prognostic value of nonsustained ventricular tachycardia (NSVT) in total mortality in severe congestive heart failure (CHF) and predictive value of NSVT as a marker for sudden death or death due to progressive heart failure. &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 516, NSVT: 173 (33.5%), No NSVT: and 343 (66.5&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality - NSVT: 87(50.3%) No NSVT: (30.9%) (RR = 1.69 (95% confidence interval [CI], 1.27 to 2.24; P&amp;lt;.0002; Cox proportional hazard analysis was 1.62 (95% CI, 1.22 to 2.16; P&amp;lt;.001)). Sudden death – No NSVT: 8.7%, NSVT: 23.7% (RR, 2.77; 95% CI, 1.78 to 4.44; P&amp;lt;.001). Progressive heart failure death – No NSVT: 17.5%, NSVT: 20.8% (P=.22). Couplets prediction of total all-cause mortality: RR, 1.81; 95% CI, 1.22 to 2.66; P&amp;lt;.002 ; sudden death: RR, 3.37; 95% CI, 1.57 to 7.25; P&amp;lt;.0005. Couplets±NSVT prediction of sudden death: RR, 10.1; 95% CI, 1.91 to 52.7; P&amp;lt;.01.&lt;br /&gt;
&lt;br /&gt;
7. &#039;&#039;&#039;EMIAT (The European Myocardial Infarct Amiodarone Trial)&amp;lt;ref name=&amp;quot;pmid9078197&amp;quot;&amp;gt;{{cite journal| author=Julian DG, Camm AJ, Frangin G, Janse MJ, Munoz A, Schwartz PJ et al.| title=Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT. European Myocardial Infarct Amiodarone Trial Investigators. | journal=Lancet | year= 1997 | volume= 349 | issue= 9053 | pages= 667-74 | pmid=9078197 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=9078197  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone effect on reduction of mortality in patients of myocardial infarction with impaired ventricular function, irrespective of whether they had ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1486, Amiodarone : 743, Placebo : 743&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone group, there was a 35% risk reduction (95% CI 0–58, p=0.05) in arrhythmic deaths.&lt;br /&gt;
&lt;br /&gt;
8. &#039;&#039;&#039;CAMIAT (The Cardiac Arrhythmia Suppression Trial)&amp;lt;ref name=&amp;quot;pmid9078198&amp;quot;&amp;gt;{{cite journal| author=Cairns JA, Connolly SJ, Roberts R, Gent M| title=Randomised trial of outcome after myocardial infarction in patients with frequent or repetitive ventricular premature depolarisations: CAMIAT. Canadian Amiodarone Myocardial Infarction Arrhythmia Trial Investigators. | journal=Lancet | year= 1997 | volume= 349 | issue= 9053 | pages= 675-82 | pmid=9078198 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=9078198  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess the effect of amiodarone on the risk of resuscitated ventricular fibrillation or arrhythmic death among survivors of myocardial infarction with frequent or repetitive VPDs (≥10 VPDs per h or ≥1 run of ventricular tachycardia).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 1202, Amiodarone :  606, Placebo: 596&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;:&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Analysis: resuscitated ventricular fibrillation or arrhythmic death – Placebo : 31 (6.0%) Amiodarone : 15 (3.3%) (relative-risk reduction 48.5% [95% CI 4.5 to 72.2], p=0.016). Intention-to-treat analysis: primary outcome events Placebo : 24 (6.9%) Amiodarone : 15 (4.5 (38.2% [95% CI –2.1 to 62.6], p=0.029). The absolute-risk reductions were greatest among patients with congestive heart failure or a history of myocardial infarction.&lt;br /&gt;
&lt;br /&gt;
9. &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&amp;lt;ref name=&amp;quot;pmid10086963&amp;quot;&amp;gt;{{cite journal| author=Bigger JT, Whang W, Rottman JN, Kleiger RE, Gottlieb CD, Namerow PB et al.| title=Mechanisms of death in the CABG Patch trial: a randomized trial of implantable cardiac defibrillator prophylaxis in patients at high risk of death after coronary artery bypass graft surgery. | journal=Circulation | year= 1999 | volume= 99 | issue= 11 | pages= 1416-21 | pmid=10086963 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
10. &#039;&#039;&#039;MUSTT (the Multicenter Unsustained Tachycardia Trial)&amp;lt;ref name=&amp;quot;pmid10601507&amp;quot;&amp;gt;{{cite journal| author=Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EN, Hafley G| title=A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators. | journal=N Engl J Med | year= 1999 | volume= 341 | issue= 25 | pages= 1882-90 | pmid=10601507 | doi=10.1056/NEJM199912163412503 | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Electrophysiologically guided antiarrhythmic therapy would reduce the risk of sudden death among patients with coronary artery disease, a left ventricular ejection fraction of 40 percent or less, and asymptomatic, unsustained ventricular tachycardia&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: 704 patients who underwent randomization, 351 were assigned to receive electrophysiologically guided therapy and 353 were assigned to receive no antiarrhythmic therapy.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: LVEF &amp;lt;40% + NSVT&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study:  Cardiac Arrest or Death from Arrhythmia - EP guided therapy = 25% no antiarrhythmic therapy = 32% (RR=0.73, CI=0.53-0.99). Cardiac arrest or death from arrhythmia - Treatment with Defibrillators vs w/o Defibrillator Treatment (RR=0.24; CI=0.13-0.45; P&amp;lt;0.001). &lt;br /&gt;
&lt;br /&gt;
11. &#039;&#039;&#039;MADIT II (Multicenter Automatic Defibrillator Implantation Trial - II)&amp;lt;ref name=&amp;quot;pmid11907286&amp;quot;&amp;gt;{{cite journal| author=Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS et al.| title=Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. | journal=N Engl J Med | year= 2002 | volume= 346 | issue= 12 | pages= 877-83 | pmid=11907286 | doi=10.1056/NEJMoa013474 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=11907286  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=12418821 Review in: ACP J Club. 2002 Nov-Dec;137(3):81] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To evaluate the effect of an implantable defibrillator on survival in patients with reduced left ventricular function after myocardial infarction are at risk for life threatening ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1232, ICD: 742, Conventional Medical Therapy: 490 patients&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤30% &amp;gt;10 PVCs/hr or couplets&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality – Conventional Medical Therapy: 19.8%, ICD: 14.2%(HR 0.69 (95 CI= 0.51-0.93, P=0.016).&lt;br /&gt;
&lt;br /&gt;
12. &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&amp;lt;ref name=&amp;quot;pmid12767651&amp;quot;&amp;gt;{{cite journal| author=Strickberger SA, Hummel JD, Bartlett TG, Frumin HI, Schuger CD, Beau SL et al.| title=Amiodarone versus implantable cardioverter-defibrillator:randomized trial in patients with nonischemic dilated cardiomyopathy and asymptomatic nonsustained ventricular tachycardia--AMIOVIRT. | journal=J Am Coll Cardiol | year= 2003 | volume= 41 | issue= 10 | pages= 1707-12 | pmid=12767651 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=12767651  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
13. &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&amp;lt;ref name=&amp;quot;pmid15152060&amp;quot;&amp;gt;{{cite journal| author=Kadish A, Dyer A, Daubert JP, Quigg R, Estes NA, Anderson KP et al.| title=Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. | journal=N Engl J Med | year= 2004 | volume= 350 | issue= 21 | pages= 2151-8 | pmid=15152060 | doi=10.1056/NEJMoa033088 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15152060  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15518445 Review in: ACP J Club. 2004 Nov-Dec;141(3):61] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
14. &#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&amp;lt;ref name=&amp;quot;pmid15590950&amp;quot;&amp;gt;{{cite journal| author=Hohnloser SH, Kuck KH, Dorian P, Roberts RS, Hampton JR, Hatala R et al.| title=Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. | journal=N Engl J Med | year= 2004 | volume= 351 | issue= 24 | pages= 2481-8 | pmid=15590950 | doi=10.1056/NEJMoa041489 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15590950  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15862057 Review in: ACP J Club. 2005 May-Jun;142(3):58] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
15. &#039;&#039;&#039;COMPANION (The Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure trial )&amp;lt;ref name=&amp;quot;pmid15152059&amp;quot;&amp;gt;{{cite journal| author=Bristow MR, Saxon LA, Boehmer J, Krueger S, Kass DA, De Marco T et al.| title=Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. | journal=N Engl J Med | year= 2004 | volume= 350 | issue= 21 | pages= 2140-50 | pmid=15152059 | doi=10.1056/NEJMoa032423 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15152059  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15518444 Review in: ACP J Club. 2004 Nov-Dec;141(3):60] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Prophylactic cardiac-resynchronization therapy in the form of biventricular stimulation with a pacemaker with or without a defibrillator would reduce the risk of death and hospitalization among patients with advanced chronic heart failure and intraventricular conduction delays.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1520, Optimal Pharmacologic Therapy: 308, Cardiac- Resynchronization Therapy:  Pacemaker=617, Pacemaker– Defibrillator=595&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: Ischemic or nonischemic CM NYHA Class III-IV QRS ≥120 msec&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Pacemaker group - Primary end point mortality reduction (hazard ratio, 0.81; P=0.014), Pacemaker–defibrillator group (hazard ratio, 0.80; P=0.01). Primary end point mortality reduction: 34% - Pacemaker group (P&amp;lt;0.002), 40% - Pacemaker–Defibrillator group (P&amp;lt;0.001). Secondary end point mortality reduction: 24% - Pacemaker group (P=0.059), 36% - Pacemaker–Defibrillator group (P=0.003). &lt;br /&gt;
&lt;br /&gt;
16. &#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&amp;lt;ref name=&amp;quot;pmid15659722&amp;quot;&amp;gt;{{cite journal| author=Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, Boineau R et al.| title=Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. | journal=N Engl J Med | year= 2005 | volume= 352 | issue= 3 | pages= 225-37 | pmid=15659722 | doi=10.1056/NEJMoa043399 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15659722  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15989294 Review in: ACP J Club. 2005 Jul-Aug;143(1):6] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
17. MADIT-CRT(Multicenter automatic defibrillator implantation trial-cardiac resynchronization therapy)&amp;lt;ref name=&amp;quot;pmid19723701&amp;quot;&amp;gt;{{cite journal| author=Moss AJ, Hall WJ, Cannom DS, Klein H, Brown MW, Daubert JP et al.| title=Cardiac-resynchronization therapy for the prevention of heart-failure events. | journal=N Engl J Med | year= 2009 | volume= 361 | issue= 14 | pages= 1329-38 | pmid=19723701 | doi=10.1056/NEJMoa0906431 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=19723701  }} &amp;lt;/ref&amp;gt;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To determine whether cardiac-resynchronization therapy (CRT) with biventricular pacing would reduce the risk of death or heart-failure events in patients with mild cardiac symptoms, a reduced ejection fraction, and a wide QRS complex.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 1820, CRT + ICD = 1089, ICD alone = 731&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;30%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy study: CRT-ICD primary end point mortality = 17.2%, ICD-only group = 25.3% HR=0.66; 95% CI = 0.52-0.84, p=0.001. &lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=620324</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=620324"/>
		<updated>2012-01-12T23:17:48Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;CASCADE(The Cardiac Arrest in Seatle Conventional Versus Amiodarone Drug Evaluation study)&amp;lt;ref name=&amp;quot;pmid8237833&amp;quot;&amp;gt;{{cite journal| author=Greene HL| title=The CASCADE Study: randomized antiarrhythmic drug therapy in survivors of cardiac arrest in Seattle. CASCADE Investigators. | journal=Am J Cardiol | year= 1993 | volume= 72 | issue= 16 | pages= 70F-74F | pmid=8237833 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone vs conventional therapy in patients with/without AICD&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 228 Amiodarone: 113 conventional antiarrhythmic drugs: 115(quinidine (n=33), procainamide (n = 26), combination therapy (n = 17), flecainide (n = 12). AICD: 105 (Amiodarone: 53, Conventional therapy: 52)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 13% more survival in patient population at the primary end point (total cardiac mortality, resuscitated cardiac arrest due to ventricular fibrillation, and syncopal Implanted defibrillator shocks) at the end of 6 years. (p=0.007).  With AICD 16% survival more at the primary end point( shocks preceded by complete syncope)(p=0.032) conclusively showing superiority of Amidarone over convetional therapy in secondary prevention.&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039; ESVEM (Electrophysiologic Study Versus Electrocardiographic Monitoring for Selection of Antiarrhythmic Therapy of Ventricular Tachyarrhythmias)&amp;lt;ref name=&amp;quot;pmid8332149&amp;quot;&amp;gt;{{cite journal| author=Mason JW| title=A comparison of electrophysiologic testing with Holter monitoring to predict antiarrhythmic-drug efficacy for ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. | journal=N Engl J Med | year= 1993 | volume= 329 | issue= 7 | pages= 445-51 | pmid=8332149 | doi=10.1056/NEJM199308123290701 | pmc= | url= }} &amp;lt;/ref&amp;gt;&amp;lt;ref name=&amp;quot;pmid8332150&amp;quot;&amp;gt;{{cite journal| author=Mason JW| title=A comparison of seven antiarrhythmic drugs in patients with ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. | journal=N Engl J Med | year= 1993 | volume= 329 | issue= 7 | pages= 452-8 | pmid=8332150 | doi=10.1056/NEJM199308123290702 | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: EP testing and Holter monitor of 7 antiarrhythmics (imipramine, mexiletine, procainamide, quinidine, sotalol, pirmenol, propafenone)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  486 patients were randomized and 296 patients were eventually followed up.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 33% in all 296 and 34% in Sotalol group&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  No difference between Holter- and EP-guided groups. Sotalol group had lowest recurrence rate of VT (risk ratio, 0.43; 95 percent confidence interval, 0.29 to 0.62; p&amp;lt;0.001), arrhythmic death (risk ratio, 0.50; 95 percent confidence interval, 0.26 to 0.96; P = 0.04), total death (risk ratio, 0.50; 95 percent confidence interval, 0.30 to 0.80; P = 0.004).&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&amp;lt;ref name=&amp;quot;pmid9411221&amp;quot;&amp;gt;{{cite journal| author=| title=A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. The Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators. | journal=N Engl J Med | year= 1997 | volume= 337 | issue= 22 | pages= 1576-83 | pmid=9411221 | doi=10.1056/NEJM199711273372202 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&amp;lt;ref name=&amp;quot;pmid10725290&amp;quot;&amp;gt;{{cite journal| author=Connolly SJ, Gent M, Roberts RS, Dorian P, Roy D, Sheldon RS et al.| title=Canadian implantable defibrillator study (CIDS) : a randomized trial of the implantable cardioverter defibrillator against amiodarone. | journal=Circulation | year= 2000 | volume= 101 | issue= 11 | pages= 1297-302 | pmid=10725290 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&amp;lt;ref name=&amp;quot;pmid10942742&amp;quot;&amp;gt;{{cite journal| author=Kuck KH, Cappato R, Siebels J, Rüppel R| title=Randomized comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from cardiac arrest : the Cardiac Arrest Study Hamburg (CASH). | journal=Circulation | year= 2000 | volume= 102 | issue= 7 | pages= 748-54 | pmid=10942742 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039; BHAT  ( β-Blocker Heart Attack Trial)&amp;lt;ref name=&amp;quot;pmid7038157&amp;quot;&amp;gt;{{cite journal| author=| title=A randomized trial of propranolol in patients with acute myocardial infarction. I. Mortality results. | journal=JAMA | year= 1982 | volume= 247 | issue= 12 | pages= 1707-14 | pmid=7038157 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039; : multicenter, randomized, double-blind, and placebo-controlled trial designed to test whether the regular administration of propranolol hydrochloride to men and women who had experienced at least one myocardial infarction would result in a significant reduction in total mortality during a two- to four-year period.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 3837, Propanolol: 1916, Placebo: 1921 persons, five to 21 days after the infarction.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Total mortality during the average 25-month follow-up period was 7.2% in the propranolol group and 9.8% in the placebo group. Arteriosclerotic heart disease (ASHD) mortality was 6.2% in the propranolol group and 8.5% in the placebo group. &lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CAST (The Cardiac Arrhythmia Suppression Trial)&amp;lt;ref name=&amp;quot;pmid1900101&amp;quot;&amp;gt;{{cite journal| author=Echt DS, Liebson PR, Mitchell LB, Peters RW, Obias-Manno D, Barker AH et al.| title=Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. | journal=N Engl J Med | year= 1991 | volume= 324 | issue= 12 | pages= 781-8 | pmid=1900101 | doi=10.1056/NEJM199103213241201 | pmc= | url= }} &amp;lt;/ref&amp;gt;&amp;lt;ref name=&amp;quot;pmid1377359&amp;quot;&amp;gt;{{cite journal| author=| title=Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. The Cardiac Arrhythmia Suppression Trial II Investigators. | journal=N Engl J Med | year= 1992 | volume= 327 | issue= 4 | pages= 227-33 | pmid=1377359 | doi=10.1056/NEJM199207233270403 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Suppression of ventricular ectopy after a myocardial infarction reduces the incidence of sudden death, patients in whom ventricular ectopy could be suppressed with encainide, flecainide, or moricizine were randomly assigned to receive either active drug or placebo&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1498 patients,Encainide+Placebo: 857(432 to active drug and 425 to placebo), Flecainide+Placebo: 641 (323 to active drug and 318 to placebo).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 89 patients had died: 59 of arrhythmia (43 receiving drug vs. 16 receiving placebo; P = 0.0004), 22 of nonarrhythmic cardiac causes (17 receiving drug vs. 5 receiving placebo; P = 0.01), and 8 of noncardiac causes (3 receiving drug vs. 5 receiving placebo). Almost all cardiac deaths not due to arrhythmia were attributed to acute myocardial infarction with shock (11 patients receiving drug and 3 receiving placebo) or to chronic congestive heart failure (4 receiving drug and 2 receiving placebo). There were no differences between the patients receiving active drug and those receiving placebo in the incidence of nonlethal disqualifying ventricular tachycardia, proarrhythmia, syncope, need for a permanent pacemaker, congestive heart failure, recurrent myocardial infarction, angina, or need for coronary-artery bypass grafting or angioplasty.&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;CHF-STAT (Congestive heart failure: Survival trial of antiarrhythmic therapy)&amp;lt;ref name=&amp;quot;pmid7539890&amp;quot;&amp;gt;{{cite journal| author=Singh SN, Fletcher RD, Fisher SG, Singh BN, Lewis HD, Deedwania PC et al.| title=Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia. Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure. | journal=N Engl J Med | year= 1995 | volume= 333 | issue= 2 | pages= 77-82 | pmid=7539890 | doi=10.1056/NEJM199507133330201 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 674, Amiodarone: 336, Placebo: 338&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: to determine whether Amiodarone can reduce overall mortality in patients with congestive heart failure and asymptomatic ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%, ≥10 PVCs/hr&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: The rate of sudden death was 15% in the Amiodarone group and 19% in the placebo group in Ischemic Cardiomyopathy group (P=0.43). Reduction in overall mortality among the patients with nonischemic cardiomyopathy who received Amiodarone (P =0.07).&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039; SWORD (The Survival With Oral d-Sotalol trial)&amp;lt;ref name=&amp;quot;pmid8691967&amp;quot;&amp;gt;{{cite journal| author=Waldo AL, Camm AJ, deRuyter H, Friedman PL, MacNeil DJ, Pauls JF et al.| title=Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. The SWORD Investigators. Survival With Oral d-Sotalol. | journal=Lancet | year= 1996 | volume= 348 | issue= 9019 | pages= 7-12 | pmid=8691967 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=8691967  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;:  whether d-sotalol, could reduce all-cause mortality in patients with Left ventricular dysfunction after myocardial infarction .&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 3121, d-Sotalol : 1549, placebo : 1572 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  Mortality : d-sotalol: 78 deaths (5.0%), Placebo: 48 deaths (3.1%) (relative risk 1.65 [95% CI 115–2.36], p=0.006). Presumed arrhythmic deaths (relative risk 1.77 [1.15–2.74], p=0.008). The effect was greater in patients with a left ventricular ejection fraction of 31–40% than in those with lower (≤30%) ejection fractions (relative risk 4.0 vs 1.2, p=0.007).&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&amp;lt;ref name=&amp;quot;pmid8960472&amp;quot;&amp;gt;{{cite journal| author=Moss AJ, Hall WJ, Cannom DS, Daubert JP, Higgins SL, Klein H et al.| title=Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators. | journal=N Engl J Med | year= 1996 | volume= 335 | issue= 26 | pages= 1933-40 | pmid=8960472 | doi=10.1056/NEJM199612263352601 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
6. &#039;&#039;&#039;GESICA (the Gruppo de Estudo de la Sobrevida en la Insuficiencia Cardiaca en Argentina)&amp;lt;ref name=&amp;quot;pmid8989129&amp;quot;&amp;gt;{{cite journal| author=Doval HC, Nul DR, Grancelli HO, Varini SD, Soifer S, Corrado G et al.| title=Nonsustained ventricular tachycardia in severe heart failure. Independent marker of increased mortality due to sudden death. GESICA-GEMA Investigators. | journal=Circulation | year= 1996 | volume= 94 | issue= 12 | pages= 3198-203 | pmid=8989129 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To determine the prognostic value of nonsustained ventricular tachycardia (NSVT) in total mortality in severe congestive heart failure (CHF) and predictive value of NSVT as a marker for sudden death or death due to progressive heart failure. &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 516, NSVT: 173 (33.5%), No NSVT: and 343 (66.5&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality - NSVT: 87(50.3%) No NSVT: (30.9%) (RR = 1.69 (95% confidence interval [CI], 1.27 to 2.24; P&amp;lt;.0002; Cox proportional hazard analysis was 1.62 (95% CI, 1.22 to 2.16; P&amp;lt;.001)). Sudden death – No NSVT: 8.7%, NSVT: 23.7% (RR, 2.77; 95% CI, 1.78 to 4.44; P&amp;lt;.001). Progressive heart failure death – No NSVT: 17.5%, NSVT: 20.8% (P=.22). Couplets prediction of total all-cause mortality: RR, 1.81; 95% CI, 1.22 to 2.66; P&amp;lt;.002 ; sudden death: RR, 3.37; 95% CI, 1.57 to 7.25; P&amp;lt;.0005. Couplets±NSVT prediction of sudden death: RR, 10.1; 95% CI, 1.91 to 52.7; P&amp;lt;.01.&lt;br /&gt;
&lt;br /&gt;
7. &#039;&#039;&#039;EMIAT (The European Myocardial Infarct Amiodarone Trial)&amp;lt;ref name=&amp;quot;pmid9078197&amp;quot;&amp;gt;{{cite journal| author=Julian DG, Camm AJ, Frangin G, Janse MJ, Munoz A, Schwartz PJ et al.| title=Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT. European Myocardial Infarct Amiodarone Trial Investigators. | journal=Lancet | year= 1997 | volume= 349 | issue= 9053 | pages= 667-74 | pmid=9078197 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=9078197  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone effect on reduction of mortality in patients of myocardial infarction with impaired ventricular function, irrespective of whether they had ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1486, Amiodarone : 743, Placebo : 743&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone group, there was a 35% risk reduction (95% CI 0–58, p=0.05) in arrhythmic deaths.&lt;br /&gt;
&lt;br /&gt;
8. &#039;&#039;&#039;CAMIAT (The Cardiac Arrhythmia Suppression Trial)&amp;lt;ref name=&amp;quot;pmid9078198&amp;quot;&amp;gt;{{cite journal| author=Cairns JA, Connolly SJ, Roberts R, Gent M| title=Randomised trial of outcome after myocardial infarction in patients with frequent or repetitive ventricular premature depolarisations: CAMIAT. Canadian Amiodarone Myocardial Infarction Arrhythmia Trial Investigators. | journal=Lancet | year= 1997 | volume= 349 | issue= 9053 | pages= 675-82 | pmid=9078198 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=9078198  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess the effect of amiodarone on the risk of resuscitated ventricular fibrillation or arrhythmic death among survivors of myocardial infarction with frequent or repetitive VPDs (≥10 VPDs per h or ≥1 run of ventricular tachycardia).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 1202, Amiodarone :  606, Placebo: 596&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;:&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Analysis: resuscitated ventricular fibrillation or arrhythmic death – Placebo : 31 (6.0%) Amiodarone : 15 (3.3%) (relative-risk reduction 48.5% [95% CI 4.5 to 72.2], p=0.016). Intention-to-treat analysis: primary outcome events Placebo : 24 (6.9%) Amiodarone : 15 (4.5 (38.2% [95% CI –2.1 to 62.6], p=0.029). The absolute-risk reductions were greatest among patients with congestive heart failure or a history of myocardial infarction.&lt;br /&gt;
&lt;br /&gt;
9. &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&amp;lt;ref name=&amp;quot;pmid10086963&amp;quot;&amp;gt;{{cite journal| author=Bigger JT, Whang W, Rottman JN, Kleiger RE, Gottlieb CD, Namerow PB et al.| title=Mechanisms of death in the CABG Patch trial: a randomized trial of implantable cardiac defibrillator prophylaxis in patients at high risk of death after coronary artery bypass graft surgery. | journal=Circulation | year= 1999 | volume= 99 | issue= 11 | pages= 1416-21 | pmid=10086963 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
10. &#039;&#039;&#039;MUSTT (the Multicenter Unsustained Tachycardia Trial)&amp;lt;ref name=&amp;quot;pmid10601507&amp;quot;&amp;gt;{{cite journal| author=Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EN, Hafley G| title=A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators. | journal=N Engl J Med | year= 1999 | volume= 341 | issue= 25 | pages= 1882-90 | pmid=10601507 | doi=10.1056/NEJM199912163412503 | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Electrophysiologically guided antiarrhythmic therapy would reduce the risk of sudden death among patients with coronary artery disease, a left ventricular ejection fraction of 40 percent or less, and asymptomatic, unsustained ventricular tachycardia&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: 704 patients who underwent randomization, 351 were assigned to receive electrophysiologically guided therapy and 353 were assigned to receive no antiarrhythmic therapy.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: LVEF &amp;lt;40% + NSVT&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study:  Cardiac Arrest or Death from Arrhythmia - EP guided therapy = 25% no antiarrhythmic therapy = 32% (RR=0.73, CI=0.53-0.99). Cardiac arrest or death from arrhythmia - Treatment with Defibrillators vs w/o Defibrillator Treatment (RR=0.24; CI=0.13-0.45; P&amp;lt;0.001). &lt;br /&gt;
&lt;br /&gt;
11. &#039;&#039;&#039;MADIT II (Multicenter Automatic Defibrillator Implantation Trial - II)&amp;lt;ref name=&amp;quot;pmid11907286&amp;quot;&amp;gt;{{cite journal| author=Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS et al.| title=Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. | journal=N Engl J Med | year= 2002 | volume= 346 | issue= 12 | pages= 877-83 | pmid=11907286 | doi=10.1056/NEJMoa013474 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=11907286  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=12418821 Review in: ACP J Club. 2002 Nov-Dec;137(3):81] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To evaluate the effect of an implantable defibrillator on survival in patients with reduced left ventricular function after myocardial infarction are at risk for life threatening ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1232, ICD: 742, Conventional Medical Therapy: 490 patients&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤30% &amp;gt;10 PVCs/hr or couplets&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality – Conventional Medical Therapy: 19.8%, ICD: 14.2%(HR 0.69 (95 CI= 0.51-0.93, P=0.016).&lt;br /&gt;
&lt;br /&gt;
12. &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&amp;lt;ref name=&amp;quot;pmid12767651&amp;quot;&amp;gt;{{cite journal| author=Strickberger SA, Hummel JD, Bartlett TG, Frumin HI, Schuger CD, Beau SL et al.| title=Amiodarone versus implantable cardioverter-defibrillator:randomized trial in patients with nonischemic dilated cardiomyopathy and asymptomatic nonsustained ventricular tachycardia--AMIOVIRT. | journal=J Am Coll Cardiol | year= 2003 | volume= 41 | issue= 10 | pages= 1707-12 | pmid=12767651 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=12767651  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
13. &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&amp;lt;ref name=&amp;quot;pmid15152060&amp;quot;&amp;gt;{{cite journal| author=Kadish A, Dyer A, Daubert JP, Quigg R, Estes NA, Anderson KP et al.| title=Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. | journal=N Engl J Med | year= 2004 | volume= 350 | issue= 21 | pages= 2151-8 | pmid=15152060 | doi=10.1056/NEJMoa033088 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15152060  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15518445 Review in: ACP J Club. 2004 Nov-Dec;141(3):61] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
14. &#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&amp;lt;ref name=&amp;quot;pmid15590950&amp;quot;&amp;gt;{{cite journal| author=Hohnloser SH, Kuck KH, Dorian P, Roberts RS, Hampton JR, Hatala R et al.| title=Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. | journal=N Engl J Med | year= 2004 | volume= 351 | issue= 24 | pages= 2481-8 | pmid=15590950 | doi=10.1056/NEJMoa041489 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15590950  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15862057 Review in: ACP J Club. 2005 May-Jun;142(3):58] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
15. &#039;&#039;&#039;COMPANION (The Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure trial )&amp;lt;ref name=&amp;quot;pmid15152059&amp;quot;&amp;gt;{{cite journal| author=Bristow MR, Saxon LA, Boehmer J, Krueger S, Kass DA, De Marco T et al.| title=Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. | journal=N Engl J Med | year= 2004 | volume= 350 | issue= 21 | pages= 2140-50 | pmid=15152059 | doi=10.1056/NEJMoa032423 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15152059  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15518444 Review in: ACP J Club. 2004 Nov-Dec;141(3):60] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Prophylactic cardiac-resynchronization therapy in the form of biventricular stimulation with a pacemaker with or without a defibrillator would reduce the risk of death and hospitalization among patients with advanced chronic heart failure and intraventricular conduction delays.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1520, Optimal Pharmacologic Therapy: 308, Cardiac- Resynchronization Therapy:  Pacemaker=617, Pacemaker– Defibrillator=595&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: Ischemic or nonischemic CM NYHA Class III-IV QRS ≥120 msec&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Pacemaker group - Primary end point mortality reduction (hazard ratio, 0.81; P=0.014), Pacemaker–defibrillator group (hazard ratio, 0.80; P=0.01). Primary end point mortality reduction: 34% - Pacemaker group (P&amp;lt;0.002), 40% - Pacemaker–Defibrillator group (P&amp;lt;0.001). Secondary end point mortality reduction: 24% - Pacemaker group (P=0.059), 36% - Pacemaker–Defibrillator group (P=0.003). &lt;br /&gt;
&lt;br /&gt;
16. &#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&amp;lt;ref name=&amp;quot;pmid15659722&amp;quot;&amp;gt;{{cite journal| author=Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, Boineau R et al.| title=Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. | journal=N Engl J Med | year= 2005 | volume= 352 | issue= 3 | pages= 225-37 | pmid=15659722 | doi=10.1056/NEJMoa043399 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15659722  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15989294 Review in: ACP J Club. 2005 Jul-Aug;143(1):6] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
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{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=620323</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=620323"/>
		<updated>2012-01-12T23:15:45Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: /* Landmark Clinical Trials */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;CASCADE(The Cardiac Arrest in Seatle Conventional Versus Amiodarone Drug Evaluation study)&amp;lt;ref name=&amp;quot;pmid8237833&amp;quot;&amp;gt;{{cite journal| author=Greene HL| title=The CASCADE Study: randomized antiarrhythmic drug therapy in survivors of cardiac arrest in Seattle. CASCADE Investigators. | journal=Am J Cardiol | year= 1993 | volume= 72 | issue= 16 | pages= 70F-74F | pmid=8237833 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone vs conventional therapy in patients with/without AICD&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 228 Amiodarone: 113 conventional antiarrhythmic drugs: 115(quinidine (n=33), procainamide (n = 26), combination therapy (n = 17), flecainide (n = 12). AICD: 105 (Amiodarone: 53, Conventional therapy: 52)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 13% more survival in patient population at the primary end point (total cardiac mortality, resuscitated cardiac arrest due to ventricular fibrillation, and syncopal Implanted defibrillator shocks) at the end of 6 years. (p=0.007).  With AICD 16% survival more at the primary end point( shocks preceded by complete syncope)(p=0.032) conclusively showing superiority of Amidarone over convetional therapy in secondary prevention.&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039; ESVEM (Electrophysiologic Study Versus Electrocardiographic Monitoring for Selection of Antiarrhythmic Therapy of Ventricular Tachyarrhythmias)&amp;lt;ref name=&amp;quot;pmid8332149&amp;quot;&amp;gt;{{cite journal| author=Mason JW| title=A comparison of electrophysiologic testing with Holter monitoring to predict antiarrhythmic-drug efficacy for ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. | journal=N Engl J Med | year= 1993 | volume= 329 | issue= 7 | pages= 445-51 | pmid=8332149 | doi=10.1056/NEJM199308123290701 | pmc= | url= }} &amp;lt;/ref&amp;gt;&amp;lt;ref name=&amp;quot;pmid8332150&amp;quot;&amp;gt;{{cite journal| author=Mason JW| title=A comparison of seven antiarrhythmic drugs in patients with ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. | journal=N Engl J Med | year= 1993 | volume= 329 | issue= 7 | pages= 452-8 | pmid=8332150 | doi=10.1056/NEJM199308123290702 | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: EP testing and Holter monitor of 7 antiarrhythmics (imipramine, mexiletine, procainamide, quinidine, sotalol, pirmenol, propafenone)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  486 patients were randomized and 296 patients were eventually followed up.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 33% in all 296 and 34% in Sotalol group&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  No difference between Holter- and EP-guided groups. Sotalol group had lowest recurrence rate of VT (risk ratio, 0.43; 95 percent confidence interval, 0.29 to 0.62; p&amp;lt;0.001), arrhythmic death (risk ratio, 0.50; 95 percent confidence interval, 0.26 to 0.96; P = 0.04), total death (risk ratio, 0.50; 95 percent confidence interval, 0.30 to 0.80; P = 0.004).&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&amp;lt;ref name=&amp;quot;pmid9411221&amp;quot;&amp;gt;{{cite journal| author=| title=A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. The Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators. | journal=N Engl J Med | year= 1997 | volume= 337 | issue= 22 | pages= 1576-83 | pmid=9411221 | doi=10.1056/NEJM199711273372202 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&amp;lt;ref name=&amp;quot;pmid10725290&amp;quot;&amp;gt;{{cite journal| author=Connolly SJ, Gent M, Roberts RS, Dorian P, Roy D, Sheldon RS et al.| title=Canadian implantable defibrillator study (CIDS) : a randomized trial of the implantable cardioverter defibrillator against amiodarone. | journal=Circulation | year= 2000 | volume= 101 | issue= 11 | pages= 1297-302 | pmid=10725290 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&amp;lt;ref name=&amp;quot;pmid10942742&amp;quot;&amp;gt;{{cite journal| author=Kuck KH, Cappato R, Siebels J, Rüppel R| title=Randomized comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from cardiac arrest : the Cardiac Arrest Study Hamburg (CASH). | journal=Circulation | year= 2000 | volume= 102 | issue= 7 | pages= 748-54 | pmid=10942742 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039; BHAT  ( β-Blocker Heart Attack Trial)&amp;lt;ref name=&amp;quot;pmid7038157&amp;quot;&amp;gt;{{cite journal| author=| title=A randomized trial of propranolol in patients with acute myocardial infarction. I. Mortality results. | journal=JAMA | year= 1982 | volume= 247 | issue= 12 | pages= 1707-14 | pmid=7038157 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039; : multicenter, randomized, double-blind, and placebo-controlled trial designed to test whether the regular administration of propranolol hydrochloride to men and women who had experienced at least one myocardial infarction would result in a significant reduction in total mortality during a two- to four-year period.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 3837, Propanolol: 1916, Placebo: 1921 persons, five to 21 days after the infarction.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Total mortality during the average 25-month follow-up period was 7.2% in the propranolol group and 9.8% in the placebo group. Arteriosclerotic heart disease (ASHD) mortality was 6.2% in the propranolol group and 8.5% in the placebo group. &lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CAST (The Cardiac Arrhythmia Suppression Trial)&amp;lt;ref name=&amp;quot;pmid1900101&amp;quot;&amp;gt;{{cite journal| author=Echt DS, Liebson PR, Mitchell LB, Peters RW, Obias-Manno D, Barker AH et al.| title=Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. | journal=N Engl J Med | year= 1991 | volume= 324 | issue= 12 | pages= 781-8 | pmid=1900101 | doi=10.1056/NEJM199103213241201 | pmc= | url= }} &amp;lt;/ref&amp;gt;&amp;lt;ref name=&amp;quot;pmid1377359&amp;quot;&amp;gt;{{cite journal| author=| title=Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. The Cardiac Arrhythmia Suppression Trial II Investigators. | journal=N Engl J Med | year= 1992 | volume= 327 | issue= 4 | pages= 227-33 | pmid=1377359 | doi=10.1056/NEJM199207233270403 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Suppression of ventricular ectopy after a myocardial infarction reduces the incidence of sudden death, patients in whom ventricular ectopy could be suppressed with encainide, flecainide, or moricizine were randomly assigned to receive either active drug or placebo&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1498 patients,Encainide+Placebo: 857(432 to active drug and 425 to placebo), Flecainide+Placebo: 641 (323 to active drug and 318 to placebo).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 89 patients had died: 59 of arrhythmia (43 receiving drug vs. 16 receiving placebo; P = 0.0004), 22 of nonarrhythmic cardiac causes (17 receiving drug vs. 5 receiving placebo; P = 0.01), and 8 of noncardiac causes (3 receiving drug vs. 5 receiving placebo). Almost all cardiac deaths not due to arrhythmia were attributed to acute myocardial infarction with shock (11 patients receiving drug and 3 receiving placebo) or to chronic congestive heart failure (4 receiving drug and 2 receiving placebo). There were no differences between the patients receiving active drug and those receiving placebo in the incidence of nonlethal disqualifying ventricular tachycardia, proarrhythmia, syncope, need for a permanent pacemaker, congestive heart failure, recurrent myocardial infarction, angina, or need for coronary-artery bypass grafting or angioplasty.&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039; SWORD (The Survival With Oral d-Sotalol trial)&amp;lt;ref name=&amp;quot;pmid8691967&amp;quot;&amp;gt;{{cite journal| author=Waldo AL, Camm AJ, deRuyter H, Friedman PL, MacNeil DJ, Pauls JF et al.| title=Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. The SWORD Investigators. Survival With Oral d-Sotalol. | journal=Lancet | year= 1996 | volume= 348 | issue= 9019 | pages= 7-12 | pmid=8691967 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=8691967  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;:  whether d-sotalol, could reduce all-cause mortality in patients with Left ventricular dysfunction after myocardial infarction .&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 3121, d-Sotalol : 1549, placebo : 1572 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  Mortality : d-sotalol: 78 deaths (5.0%), Placebo: 48 deaths (3.1%) (relative risk 1.65 [95% CI 115–2.36], p=0.006). Presumed arrhythmic deaths (relative risk 1.77 [1.15–2.74], p=0.008). The effect was greater in patients with a left ventricular ejection fraction of 31–40% than in those with lower (≤30%) ejection fractions (relative risk 4.0 vs 1.2, p=0.007).&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CHF-STAT (Congestive heart failure: Survival trial of antiarrhythmic therapy)&amp;lt;ref name=&amp;quot;pmid7539890&amp;quot;&amp;gt;{{cite journal| author=Singh SN, Fletcher RD, Fisher SG, Singh BN, Lewis HD, Deedwania PC et al.| title=Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia. Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure. | journal=N Engl J Med | year= 1995 | volume= 333 | issue= 2 | pages= 77-82 | pmid=7539890 | doi=10.1056/NEJM199507133330201 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 674, Amiodarone: 336, Placebo: 338&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: to determine whether Amiodarone can reduce overall mortality in patients with congestive heart failure and asymptomatic ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%, ≥10 PVCs/hr&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: The rate of sudden death was 15% in the Amiodarone group and 19% in the placebo group in Ischemic Cardiomyopathy group (P=0.43). Reduction in overall mortality among the patients with nonischemic cardiomyopathy who received Amiodarone (P =0.07).&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&amp;lt;ref name=&amp;quot;pmid8960472&amp;quot;&amp;gt;{{cite journal| author=Moss AJ, Hall WJ, Cannom DS, Daubert JP, Higgins SL, Klein H et al.| title=Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators. | journal=N Engl J Med | year= 1996 | volume= 335 | issue= 26 | pages= 1933-40 | pmid=8960472 | doi=10.1056/NEJM199612263352601 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
6. &#039;&#039;&#039;GESICA (the Gruppo de Estudo de la Sobrevida en la Insuficiencia Cardiaca en Argentina)&amp;lt;ref name=&amp;quot;pmid8989129&amp;quot;&amp;gt;{{cite journal| author=Doval HC, Nul DR, Grancelli HO, Varini SD, Soifer S, Corrado G et al.| title=Nonsustained ventricular tachycardia in severe heart failure. Independent marker of increased mortality due to sudden death. GESICA-GEMA Investigators. | journal=Circulation | year= 1996 | volume= 94 | issue= 12 | pages= 3198-203 | pmid=8989129 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To determine the prognostic value of nonsustained ventricular tachycardia (NSVT) in total mortality in severe congestive heart failure (CHF) and predictive value of NSVT as a marker for sudden death or death due to progressive heart failure. &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 516, NSVT: 173 (33.5%), No NSVT: and 343 (66.5&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality - NSVT: 87(50.3%) No NSVT: (30.9%) (RR = 1.69 (95% confidence interval [CI], 1.27 to 2.24; P&amp;lt;.0002; Cox proportional hazard analysis was 1.62 (95% CI, 1.22 to 2.16; P&amp;lt;.001)). Sudden death – No NSVT: 8.7%, NSVT: 23.7% (RR, 2.77; 95% CI, 1.78 to 4.44; P&amp;lt;.001). Progressive heart failure death – No NSVT: 17.5%, NSVT: 20.8% (P=.22). Couplets prediction of total all-cause mortality: RR, 1.81; 95% CI, 1.22 to 2.66; P&amp;lt;.002 ; sudden death: RR, 3.37; 95% CI, 1.57 to 7.25; P&amp;lt;.0005. Couplets±NSVT prediction of sudden death: RR, 10.1; 95% CI, 1.91 to 52.7; P&amp;lt;.01.&lt;br /&gt;
&lt;br /&gt;
7. &#039;&#039;&#039;EMIAT (The European Myocardial Infarct Amiodarone Trial)&amp;lt;ref name=&amp;quot;pmid9078197&amp;quot;&amp;gt;{{cite journal| author=Julian DG, Camm AJ, Frangin G, Janse MJ, Munoz A, Schwartz PJ et al.| title=Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT. European Myocardial Infarct Amiodarone Trial Investigators. | journal=Lancet | year= 1997 | volume= 349 | issue= 9053 | pages= 667-74 | pmid=9078197 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=9078197  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone effect on reduction of mortality in patients of myocardial infarction with impaired ventricular function, irrespective of whether they had ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1486, Amiodarone : 743, Placebo : 743&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone group, there was a 35% risk reduction (95% CI 0–58, p=0.05) in arrhythmic deaths.&lt;br /&gt;
&lt;br /&gt;
8. &#039;&#039;&#039;CAMIAT (The Cardiac Arrhythmia Suppression Trial)&amp;lt;ref name=&amp;quot;pmid9078198&amp;quot;&amp;gt;{{cite journal| author=Cairns JA, Connolly SJ, Roberts R, Gent M| title=Randomised trial of outcome after myocardial infarction in patients with frequent or repetitive ventricular premature depolarisations: CAMIAT. Canadian Amiodarone Myocardial Infarction Arrhythmia Trial Investigators. | journal=Lancet | year= 1997 | volume= 349 | issue= 9053 | pages= 675-82 | pmid=9078198 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=9078198  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess the effect of amiodarone on the risk of resuscitated ventricular fibrillation or arrhythmic death among survivors of myocardial infarction with frequent or repetitive VPDs (≥10 VPDs per h or ≥1 run of ventricular tachycardia).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 1202, Amiodarone :  606, Placebo: 596&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;:&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Analysis: resuscitated ventricular fibrillation or arrhythmic death – Placebo : 31 (6.0%) Amiodarone : 15 (3.3%) (relative-risk reduction 48.5% [95% CI 4.5 to 72.2], p=0.016). Intention-to-treat analysis: primary outcome events Placebo : 24 (6.9%) Amiodarone : 15 (4.5 (38.2% [95% CI –2.1 to 62.6], p=0.029). The absolute-risk reductions were greatest among patients with congestive heart failure or a history of myocardial infarction.&lt;br /&gt;
&lt;br /&gt;
9. &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&amp;lt;ref name=&amp;quot;pmid10086963&amp;quot;&amp;gt;{{cite journal| author=Bigger JT, Whang W, Rottman JN, Kleiger RE, Gottlieb CD, Namerow PB et al.| title=Mechanisms of death in the CABG Patch trial: a randomized trial of implantable cardiac defibrillator prophylaxis in patients at high risk of death after coronary artery bypass graft surgery. | journal=Circulation | year= 1999 | volume= 99 | issue= 11 | pages= 1416-21 | pmid=10086963 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
10. &#039;&#039;&#039;MUSTT (the Multicenter Unsustained Tachycardia Trial)&amp;lt;ref name=&amp;quot;pmid10601507&amp;quot;&amp;gt;{{cite journal| author=Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EN, Hafley G| title=A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators. | journal=N Engl J Med | year= 1999 | volume= 341 | issue= 25 | pages= 1882-90 | pmid=10601507 | doi=10.1056/NEJM199912163412503 | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Electrophysiologically guided antiarrhythmic therapy would reduce the risk of sudden death among patients with coronary artery disease, a left ventricular ejection fraction of 40 percent or less, and asymptomatic, unsustained ventricular tachycardia&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: 704 patients who underwent randomization, 351 were assigned to receive electrophysiologically guided therapy and 353 were assigned to receive no antiarrhythmic therapy.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: LVEF &amp;lt;40% + NSVT&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study:  Cardiac Arrest or Death from Arrhythmia - EP guided therapy = 25% no antiarrhythmic therapy = 32% (RR=0.73, CI=0.53-0.99). Cardiac arrest or death from arrhythmia - Treatment with Defibrillators vs w/o Defibrillator Treatment (RR=0.24; CI=0.13-0.45; P&amp;lt;0.001). &lt;br /&gt;
&lt;br /&gt;
11. &#039;&#039;&#039;MADIT II (Multicenter Automatic Defibrillator Implantation Trial - II)&amp;lt;ref name=&amp;quot;pmid11907286&amp;quot;&amp;gt;{{cite journal| author=Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS et al.| title=Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. | journal=N Engl J Med | year= 2002 | volume= 346 | issue= 12 | pages= 877-83 | pmid=11907286 | doi=10.1056/NEJMoa013474 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=11907286  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=12418821 Review in: ACP J Club. 2002 Nov-Dec;137(3):81] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To evaluate the effect of an implantable defibrillator on survival in patients with reduced left ventricular function after myocardial infarction are at risk for life threatening ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1232, ICD: 742, Conventional Medical Therapy: 490 patients&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤30% &amp;gt;10 PVCs/hr or couplets&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality – Conventional Medical Therapy: 19.8%, ICD: 14.2%(HR 0.69 (95 CI= 0.51-0.93, P=0.016).&lt;br /&gt;
&lt;br /&gt;
12. &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&amp;lt;ref name=&amp;quot;pmid12767651&amp;quot;&amp;gt;{{cite journal| author=Strickberger SA, Hummel JD, Bartlett TG, Frumin HI, Schuger CD, Beau SL et al.| title=Amiodarone versus implantable cardioverter-defibrillator:randomized trial in patients with nonischemic dilated cardiomyopathy and asymptomatic nonsustained ventricular tachycardia--AMIOVIRT. | journal=J Am Coll Cardiol | year= 2003 | volume= 41 | issue= 10 | pages= 1707-12 | pmid=12767651 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=12767651  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
13. &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&amp;lt;ref name=&amp;quot;pmid15152060&amp;quot;&amp;gt;{{cite journal| author=Kadish A, Dyer A, Daubert JP, Quigg R, Estes NA, Anderson KP et al.| title=Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. | journal=N Engl J Med | year= 2004 | volume= 350 | issue= 21 | pages= 2151-8 | pmid=15152060 | doi=10.1056/NEJMoa033088 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15152060  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15518445 Review in: ACP J Club. 2004 Nov-Dec;141(3):61] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
14. &#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&amp;lt;ref name=&amp;quot;pmid15590950&amp;quot;&amp;gt;{{cite journal| author=Hohnloser SH, Kuck KH, Dorian P, Roberts RS, Hampton JR, Hatala R et al.| title=Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. | journal=N Engl J Med | year= 2004 | volume= 351 | issue= 24 | pages= 2481-8 | pmid=15590950 | doi=10.1056/NEJMoa041489 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15590950  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15862057 Review in: ACP J Club. 2005 May-Jun;142(3):58] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
15. &#039;&#039;&#039;COMPANION (The Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure trial )&amp;lt;ref name=&amp;quot;pmid15152059&amp;quot;&amp;gt;{{cite journal| author=Bristow MR, Saxon LA, Boehmer J, Krueger S, Kass DA, De Marco T et al.| title=Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. | journal=N Engl J Med | year= 2004 | volume= 350 | issue= 21 | pages= 2140-50 | pmid=15152059 | doi=10.1056/NEJMoa032423 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15152059  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15518444 Review in: ACP J Club. 2004 Nov-Dec;141(3):60] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Prophylactic cardiac-resynchronization therapy in the form of biventricular stimulation with a pacemaker with or without a defibrillator would reduce the risk of death and hospitalization among patients with advanced chronic heart failure and intraventricular conduction delays.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1520, Optimal Pharmacologic Therapy: 308, Cardiac- Resynchronization Therapy:  Pacemaker=617, Pacemaker– Defibrillator=595&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: Ischemic or nonischemic CM NYHA Class III-IV QRS ≥120 msec&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Pacemaker group - Primary end point mortality reduction (hazard ratio, 0.81; P=0.014), Pacemaker–defibrillator group (hazard ratio, 0.80; P=0.01). Primary end point mortality reduction: 34% - Pacemaker group (P&amp;lt;0.002), 40% - Pacemaker–Defibrillator group (P&amp;lt;0.001). Secondary end point mortality reduction: 24% - Pacemaker group (P=0.059), 36% - Pacemaker–Defibrillator group (P=0.003). &lt;br /&gt;
&lt;br /&gt;
16. &#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&amp;lt;ref name=&amp;quot;pmid15659722&amp;quot;&amp;gt;{{cite journal| author=Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, Boineau R et al.| title=Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. | journal=N Engl J Med | year= 2005 | volume= 352 | issue= 3 | pages= 225-37 | pmid=15659722 | doi=10.1056/NEJMoa043399 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15659722  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15989294 Review in: ACP J Club. 2005 Jul-Aug;143(1):6] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
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{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=620322</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=620322"/>
		<updated>2012-01-12T23:13:33Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;CASCADE(The Cardiac Arrest in Seatle Conventional Versus Amiodarone Drug Evaluation study)&amp;lt;ref name=&amp;quot;pmid8237833&amp;quot;&amp;gt;{{cite journal| author=Greene HL| title=The CASCADE Study: randomized antiarrhythmic drug therapy in survivors of cardiac arrest in Seattle. CASCADE Investigators. | journal=Am J Cardiol | year= 1993 | volume= 72 | issue= 16 | pages= 70F-74F | pmid=8237833 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone vs conventional therapy in patients with/without AICD&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 228 Amiodarone: 113 conventional antiarrhythmic drugs: 115(quinidine (n=33), procainamide (n = 26), combination therapy (n = 17), flecainide (n = 12). AICD: 105 (Amiodarone: 53, Conventional therapy: 52)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 13% more survival in patient population at the primary end point (total cardiac mortality, resuscitated cardiac arrest due to ventricular fibrillation, and syncopal Implanted defibrillator shocks) at the end of 6 years. (p=0.007).  With AICD 16% survival more at the primary end point( shocks preceded by complete syncope)(p=0.032) conclusively showing superiority of Amidarone over convetional therapy in secondary prevention.&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039; ESVEM (Electrophysiologic Study Versus Electrocardiographic Monitoring for Selection of Antiarrhythmic Therapy of Ventricular Tachyarrhythmias)&amp;lt;ref name=&amp;quot;pmid8332149&amp;quot;&amp;gt;{{cite journal| author=Mason JW| title=A comparison of electrophysiologic testing with Holter monitoring to predict antiarrhythmic-drug efficacy for ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. | journal=N Engl J Med | year= 1993 | volume= 329 | issue= 7 | pages= 445-51 | pmid=8332149 | doi=10.1056/NEJM199308123290701 | pmc= | url= }} &amp;lt;/ref&amp;gt;&amp;lt;ref name=&amp;quot;pmid8332150&amp;quot;&amp;gt;{{cite journal| author=Mason JW| title=A comparison of seven antiarrhythmic drugs in patients with ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. | journal=N Engl J Med | year= 1993 | volume= 329 | issue= 7 | pages= 452-8 | pmid=8332150 | doi=10.1056/NEJM199308123290702 | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: EP testing and Holter monitor of 7 antiarrhythmics (imipramine, mexiletine, procainamide, quinidine, sotalol, pirmenol, propafenone)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  486 patients were randomized and 296 patients were eventually followed up.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 33% in all 296 and 34% in Sotalol group&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  No difference between Holter- and EP-guided groups. Sotalol group had lowest recurrence rate of VT (risk ratio, 0.43; 95 percent confidence interval, 0.29 to 0.62; p&amp;lt;0.001), arrhythmic death (risk ratio, 0.50; 95 percent confidence interval, 0.26 to 0.96; P = 0.04), total death (risk ratio, 0.50; 95 percent confidence interval, 0.30 to 0.80; P = 0.004).&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&amp;lt;ref name=&amp;quot;pmid9411221&amp;quot;&amp;gt;{{cite journal| author=| title=A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. The Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators. | journal=N Engl J Med | year= 1997 | volume= 337 | issue= 22 | pages= 1576-83 | pmid=9411221 | doi=10.1056/NEJM199711273372202 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&amp;lt;ref name=&amp;quot;pmid10725290&amp;quot;&amp;gt;{{cite journal| author=Connolly SJ, Gent M, Roberts RS, Dorian P, Roy D, Sheldon RS et al.| title=Canadian implantable defibrillator study (CIDS) : a randomized trial of the implantable cardioverter defibrillator against amiodarone. | journal=Circulation | year= 2000 | volume= 101 | issue= 11 | pages= 1297-302 | pmid=10725290 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&amp;lt;ref name=&amp;quot;pmid10942742&amp;quot;&amp;gt;{{cite journal| author=Kuck KH, Cappato R, Siebels J, Rüppel R| title=Randomized comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from cardiac arrest : the Cardiac Arrest Study Hamburg (CASH). | journal=Circulation | year= 2000 | volume= 102 | issue= 7 | pages= 748-54 | pmid=10942742 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039; BHAT  ( β-Blocker Heart Attack Trial)&amp;lt;ref name=&amp;quot;pmid7038157&amp;quot;&amp;gt;{{cite journal| author=| title=A randomized trial of propranolol in patients with acute myocardial infarction. I. Mortality results. | journal=JAMA | year= 1982 | volume= 247 | issue= 12 | pages= 1707-14 | pmid=7038157 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039; : multicenter, randomized, double-blind, and placebo-controlled trial designed to test whether the regular administration of propranolol hydrochloride to men and women who had experienced at least one myocardial infarction would result in a significant reduction in total mortality during a two- to four-year period.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 3837, Propanolol: 1916, Placebo: 1921 persons, five to 21 days after the infarction.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Total mortality during the average 25-month follow-up period was 7.2% in the propranolol group and 9.8% in the placebo group. Arteriosclerotic heart disease (ASHD) mortality was 6.2% in the propranolol group and 8.5% in the placebo group. &lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CAST (The Cardiac Arrhythmia Suppression Trial)&amp;lt;ref name=&amp;quot;pmid1900101&amp;quot;&amp;gt;{{cite journal| author=Echt DS, Liebson PR, Mitchell LB, Peters RW, Obias-Manno D, Barker AH et al.| title=Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. | journal=N Engl J Med | year= 1991 | volume= 324 | issue= 12 | pages= 781-8 | pmid=1900101 | doi=10.1056/NEJM199103213241201 | pmc= | url= }} &amp;lt;/ref&amp;gt;&amp;lt;ref name=&amp;quot;pmid1377359&amp;quot;&amp;gt;{{cite journal| author=| title=Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. The Cardiac Arrhythmia Suppression Trial II Investigators. | journal=N Engl J Med | year= 1992 | volume= 327 | issue= 4 | pages= 227-33 | pmid=1377359 | doi=10.1056/NEJM199207233270403 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Suppression of ventricular ectopy after a myocardial infarction reduces the incidence of sudden death, patients in whom ventricular ectopy could be suppressed with encainide, flecainide, or moricizine were randomly assigned to receive either active drug or placebo&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1498 patients,Encainide+Placebo: 857(432 to active drug and 425 to placebo), Flecainide+Placebo: 641 (323 to active drug and 318 to placebo).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 89 patients had died: 59 of arrhythmia (43 receiving drug vs. 16 receiving placebo; P = 0.0004), 22 of nonarrhythmic cardiac causes (17 receiving drug vs. 5 receiving placebo; P = 0.01), and 8 of noncardiac causes (3 receiving drug vs. 5 receiving placebo). Almost all cardiac deaths not due to arrhythmia were attributed to acute myocardial infarction with shock (11 patients receiving drug and 3 receiving placebo) or to chronic congestive heart failure (4 receiving drug and 2 receiving placebo). There were no differences between the patients receiving active drug and those receiving placebo in the incidence of nonlethal disqualifying ventricular tachycardia, proarrhythmia, syncope, need for a permanent pacemaker, congestive heart failure, recurrent myocardial infarction, angina, or need for coronary-artery bypass grafting or angioplasty.&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039; SWORD (The Survival With Oral d-Sotalol trial)&amp;lt;ref name=&amp;quot;pmid8691967&amp;quot;&amp;gt;{{cite journal| author=Waldo AL, Camm AJ, deRuyter H, Friedman PL, MacNeil DJ, Pauls JF et al.| title=Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. The SWORD Investigators. Survival With Oral d-Sotalol. | journal=Lancet | year= 1996 | volume= 348 | issue= 9019 | pages= 7-12 | pmid=8691967 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=8691967  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;:  whether d-sotalol, could reduce all-cause mortality in patients with Left ventricular dysfunction after myocardial infarction .&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 3121, d-Sotalol : 1549, placebo : 1572 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  Mortality : d-sotalol: 78 deaths (5.0%), Placebo: 48 deaths (3.1%) (relative risk 1.65 [95% CI 115–2.36], p=0.006). Presumed arrhythmic deaths (relative risk 1.77 [1.15–2.74], p=0.008). The effect was greater in patients with a left ventricular ejection fraction of 31–40% than in those with lower (≤30%) ejection fractions (relative risk 4.0 vs 1.2, p=0.007).&lt;br /&gt;
&lt;br /&gt;
8. &#039;&#039;&#039;CHF-STAT (Congestive heart failure: Survival trial of antiarrhythmic therapy)&amp;lt;ref name=&amp;quot;pmid7539890&amp;quot;&amp;gt;{{cite journal| author=Singh SN, Fletcher RD, Fisher SG, Singh BN, Lewis HD, Deedwania PC et al.| title=Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia. Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure. | journal=N Engl J Med | year= 1995 | volume= 333 | issue= 2 | pages= 77-82 | pmid=7539890 | doi=10.1056/NEJM199507133330201 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 674, Amiodarone: 336, Placebo: 338&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: to determine whether Amiodarone can reduce overall mortality in patients with congestive heart failure and asymptomatic ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%, ≥10 PVCs/hr&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: The rate of sudden death was 15% in the Amiodarone group and 19% in the placebo group in Ischemic Cardiomyopathy group (P=0.43). Reduction in overall mortality among the patients with nonischemic cardiomyopathy who received Amiodarone (P =0.07).&lt;br /&gt;
&lt;br /&gt;
9. &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&amp;lt;ref name=&amp;quot;pmid8960472&amp;quot;&amp;gt;{{cite journal| author=Moss AJ, Hall WJ, Cannom DS, Daubert JP, Higgins SL, Klein H et al.| title=Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators. | journal=N Engl J Med | year= 1996 | volume= 335 | issue= 26 | pages= 1933-40 | pmid=8960472 | doi=10.1056/NEJM199612263352601 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
7. &#039;&#039;&#039;GESICA (the Gruppo de Estudo de la Sobrevida en la Insuficiencia Cardiaca en Argentina)&amp;lt;ref name=&amp;quot;pmid8989129&amp;quot;&amp;gt;{{cite journal| author=Doval HC, Nul DR, Grancelli HO, Varini SD, Soifer S, Corrado G et al.| title=Nonsustained ventricular tachycardia in severe heart failure. Independent marker of increased mortality due to sudden death. GESICA-GEMA Investigators. | journal=Circulation | year= 1996 | volume= 94 | issue= 12 | pages= 3198-203 | pmid=8989129 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To determine the prognostic value of nonsustained ventricular tachycardia (NSVT) in total mortality in severe congestive heart failure (CHF) and predictive value of NSVT as a marker for sudden death or death due to progressive heart failure. &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 516, NSVT: 173 (33.5%), No NSVT: and 343 (66.5&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality - NSVT: 87(50.3%) No NSVT: (30.9%) (RR = 1.69 (95% confidence interval [CI], 1.27 to 2.24; P&amp;lt;.0002; Cox proportional hazard analysis was 1.62 (95% CI, 1.22 to 2.16; P&amp;lt;.001)). Sudden death – No NSVT: 8.7%, NSVT: 23.7% (RR, 2.77; 95% CI, 1.78 to 4.44; P&amp;lt;.001). Progressive heart failure death – No NSVT: 17.5%, NSVT: 20.8% (P=.22). Couplets prediction of total all-cause mortality: RR, 1.81; 95% CI, 1.22 to 2.66; P&amp;lt;.002 ; sudden death: RR, 3.37; 95% CI, 1.57 to 7.25; P&amp;lt;.0005. Couplets±NSVT prediction of sudden death: RR, 10.1; 95% CI, 1.91 to 52.7; P&amp;lt;.01.&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;EMIAT (The European Myocardial Infarct Amiodarone Trial)&amp;lt;ref name=&amp;quot;pmid9078197&amp;quot;&amp;gt;{{cite journal| author=Julian DG, Camm AJ, Frangin G, Janse MJ, Munoz A, Schwartz PJ et al.| title=Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT. European Myocardial Infarct Amiodarone Trial Investigators. | journal=Lancet | year= 1997 | volume= 349 | issue= 9053 | pages= 667-74 | pmid=9078197 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=9078197  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone effect on reduction of mortality in patients of myocardial infarction with impaired ventricular function, irrespective of whether they had ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1486, Amiodarone : 743, Placebo : 743&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone group, there was a 35% risk reduction (95% CI 0–58, p=0.05) in arrhythmic deaths.&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
6. &#039;&#039;&#039;CAMIAT (The Cardiac Arrhythmia Suppression Trial)&amp;lt;ref name=&amp;quot;pmid9078198&amp;quot;&amp;gt;{{cite journal| author=Cairns JA, Connolly SJ, Roberts R, Gent M| title=Randomised trial of outcome after myocardial infarction in patients with frequent or repetitive ventricular premature depolarisations: CAMIAT. Canadian Amiodarone Myocardial Infarction Arrhythmia Trial Investigators. | journal=Lancet | year= 1997 | volume= 349 | issue= 9053 | pages= 675-82 | pmid=9078198 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=9078198  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess the effect of amiodarone on the risk of resuscitated ventricular fibrillation or arrhythmic death among survivors of myocardial infarction with frequent or repetitive VPDs (≥10 VPDs per h or ≥1 run of ventricular tachycardia).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 1202, Amiodarone :  606, Placebo: 596&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;:&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Analysis: resuscitated ventricular fibrillation or arrhythmic death – Placebo : 31 (6.0%) Amiodarone : 15 (3.3%) (relative-risk reduction 48.5% [95% CI 4.5 to 72.2], p=0.016). Intention-to-treat analysis: primary outcome events Placebo : 24 (6.9%) Amiodarone : 15 (4.5 (38.2% [95% CI –2.1 to 62.6], p=0.029). The absolute-risk reductions were greatest among patients with congestive heart failure or a history of myocardial infarction.&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
10. &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&amp;lt;ref name=&amp;quot;pmid10086963&amp;quot;&amp;gt;{{cite journal| author=Bigger JT, Whang W, Rottman JN, Kleiger RE, Gottlieb CD, Namerow PB et al.| title=Mechanisms of death in the CABG Patch trial: a randomized trial of implantable cardiac defibrillator prophylaxis in patients at high risk of death after coronary artery bypass graft surgery. | journal=Circulation | year= 1999 | volume= 99 | issue= 11 | pages= 1416-21 | pmid=10086963 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
15. &#039;&#039;&#039;MUSTT (the Multicenter Unsustained Tachycardia Trial)&amp;lt;ref name=&amp;quot;pmid10601507&amp;quot;&amp;gt;{{cite journal| author=Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EN, Hafley G| title=A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators. | journal=N Engl J Med | year= 1999 | volume= 341 | issue= 25 | pages= 1882-90 | pmid=10601507 | doi=10.1056/NEJM199912163412503 | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Electrophysiologically guided antiarrhythmic therapy would reduce the risk of sudden death among patients with coronary artery disease, a left ventricular ejection fraction of 40 percent or less, and asymptomatic, unsustained ventricular tachycardia&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: 704 patients who underwent randomization, 351 were assigned to receive electrophysiologically guided therapy and 353 were assigned to receive no antiarrhythmic therapy.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: LVEF &amp;lt;40% + NSVT&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study:  Cardiac Arrest or Death from Arrhythmia - EP guided therapy = 25% no antiarrhythmic therapy = 32% (RR=0.73, CI=0.53-0.99). Cardiac arrest or death from arrhythmia - Treatment with Defibrillators vs w/o Defibrillator Treatment (RR=0.24; CI=0.13-0.45; P&amp;lt;0.001). &lt;br /&gt;
&lt;br /&gt;
16. &#039;&#039;&#039;MADIT II (Multicenter Automatic Defibrillator Implantation Trial - II)&amp;lt;ref name=&amp;quot;pmid11907286&amp;quot;&amp;gt;{{cite journal| author=Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS et al.| title=Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. | journal=N Engl J Med | year= 2002 | volume= 346 | issue= 12 | pages= 877-83 | pmid=11907286 | doi=10.1056/NEJMoa013474 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=11907286  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=12418821 Review in: ACP J Club. 2002 Nov-Dec;137(3):81] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To evaluate the effect of an implantable defibrillator on survival in patients with reduced left ventricular function after myocardial infarction are at risk for life threatening ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1232, ICD: 742, Conventional Medical Therapy: 490 patients&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤30% &amp;gt;10 PVCs/hr or couplets&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality – Conventional Medical Therapy: 19.8%, ICD: 14.2%(HR 0.69 (95 CI= 0.51-0.93, P=0.016).&lt;br /&gt;
&lt;br /&gt;
11. &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&amp;lt;ref name=&amp;quot;pmid12767651&amp;quot;&amp;gt;{{cite journal| author=Strickberger SA, Hummel JD, Bartlett TG, Frumin HI, Schuger CD, Beau SL et al.| title=Amiodarone versus implantable cardioverter-defibrillator:randomized trial in patients with nonischemic dilated cardiomyopathy and asymptomatic nonsustained ventricular tachycardia--AMIOVIRT. | journal=J Am Coll Cardiol | year= 2003 | volume= 41 | issue= 10 | pages= 1707-12 | pmid=12767651 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=12767651  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
12. &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&amp;lt;ref name=&amp;quot;pmid15152060&amp;quot;&amp;gt;{{cite journal| author=Kadish A, Dyer A, Daubert JP, Quigg R, Estes NA, Anderson KP et al.| title=Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. | journal=N Engl J Med | year= 2004 | volume= 350 | issue= 21 | pages= 2151-8 | pmid=15152060 | doi=10.1056/NEJMoa033088 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15152060  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15518445 Review in: ACP J Club. 2004 Nov-Dec;141(3):61] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
13. &#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&amp;lt;ref name=&amp;quot;pmid15590950&amp;quot;&amp;gt;{{cite journal| author=Hohnloser SH, Kuck KH, Dorian P, Roberts RS, Hampton JR, Hatala R et al.| title=Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. | journal=N Engl J Med | year= 2004 | volume= 351 | issue= 24 | pages= 2481-8 | pmid=15590950 | doi=10.1056/NEJMoa041489 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15590950  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15862057 Review in: ACP J Club. 2005 May-Jun;142(3):58] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
17. &#039;&#039;&#039;COMPANION (The Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure trial )&amp;lt;ref name=&amp;quot;pmid15152059&amp;quot;&amp;gt;{{cite journal| author=Bristow MR, Saxon LA, Boehmer J, Krueger S, Kass DA, De Marco T et al.| title=Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. | journal=N Engl J Med | year= 2004 | volume= 350 | issue= 21 | pages= 2140-50 | pmid=15152059 | doi=10.1056/NEJMoa032423 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15152059  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15518444 Review in: ACP J Club. 2004 Nov-Dec;141(3):60] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Prophylactic cardiac-resynchronization therapy in the form of biventricular stimulation with a pacemaker with or without a defibrillator would reduce the risk of death and hospitalization among patients with advanced chronic heart failure and intraventricular conduction delays.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1520, Optimal Pharmacologic Therapy: 308, Cardiac- Resynchronization Therapy:  Pacemaker=617, Pacemaker– Defibrillator=595&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: Ischemic or nonischemic CM NYHA Class III-IV QRS ≥120 msec&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Pacemaker group - Primary end point mortality reduction (hazard ratio, 0.81; P=0.014), Pacemaker–defibrillator group (hazard ratio, 0.80; P=0.01). Primary end point mortality reduction: 34% - Pacemaker group (P&amp;lt;0.002), 40% - Pacemaker–Defibrillator group (P&amp;lt;0.001). Secondary end point mortality reduction: 24% - Pacemaker group (P=0.059), 36% - Pacemaker–Defibrillator group (P=0.003). &lt;br /&gt;
&lt;br /&gt;
14. &#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&amp;lt;ref name=&amp;quot;pmid15659722&amp;quot;&amp;gt;{{cite journal| author=Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, Boineau R et al.| title=Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. | journal=N Engl J Med | year= 2005 | volume= 352 | issue= 3 | pages= 225-37 | pmid=15659722 | doi=10.1056/NEJMoa043399 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15659722  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15989294 Review in: ACP J Club. 2005 Jul-Aug;143(1):6] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
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==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
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{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=620320</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=620320"/>
		<updated>2012-01-12T23:02:53Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&amp;lt;ref name=&amp;quot;pmid9411221&amp;quot;&amp;gt;{{cite journal| author=| title=A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. The Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators. | journal=N Engl J Med | year= 1997 | volume= 337 | issue= 22 | pages= 1576-83 | pmid=9411221 | doi=10.1056/NEJM199711273372202 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&amp;lt;ref name=&amp;quot;pmid10725290&amp;quot;&amp;gt;{{cite journal| author=Connolly SJ, Gent M, Roberts RS, Dorian P, Roy D, Sheldon RS et al.| title=Canadian implantable defibrillator study (CIDS) : a randomized trial of the implantable cardioverter defibrillator against amiodarone. | journal=Circulation | year= 2000 | volume= 101 | issue= 11 | pages= 1297-302 | pmid=10725290 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&amp;lt;ref name=&amp;quot;pmid10942742&amp;quot;&amp;gt;{{cite journal| author=Kuck KH, Cappato R, Siebels J, Rüppel R| title=Randomized comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from cardiac arrest : the Cardiac Arrest Study Hamburg (CASH). | journal=Circulation | year= 2000 | volume= 102 | issue= 7 | pages= 748-54 | pmid=10942742 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CASCADE(The Cardiac Arrest in Seatle Conventional Versus Amiodarone Drug Evaluation study)&amp;lt;ref name=&amp;quot;pmid8237833&amp;quot;&amp;gt;{{cite journal| author=Greene HL| title=The CASCADE Study: randomized antiarrhythmic drug therapy in survivors of cardiac arrest in Seattle. CASCADE Investigators. | journal=Am J Cardiol | year= 1993 | volume= 72 | issue= 16 | pages= 70F-74F | pmid=8237833 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone vs conventional therapy in patients with/without AICD&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 228 Amiodarone: 113 conventional antiarrhythmic drugs: 115(quinidine (n=33), procainamide (n = 26), combination therapy (n = 17), flecainide (n = 12). AICD: 105 (Amiodarone: 53, Conventional therapy: 52)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 13% more survival in patient population at the primary end point (total cardiac mortality, resuscitated cardiac arrest due to ventricular fibrillation, and syncopal Implanted defibrillator shocks) at the end of 6 years. (p=0.007).  With AICD 16% survival more at the primary end point( shocks preceded by complete syncope)(p=0.032) conclusively showing superiority of Amidarone over convetional therapy in secondary prevention.&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039; ESVEM (Electrophysiologic Study Versus Electrocardiographic Monitoring for Selection of Antiarrhythmic Therapy of Ventricular Tachyarrhythmias)&amp;lt;ref name=&amp;quot;pmid8332149&amp;quot;&amp;gt;{{cite journal| author=Mason JW| title=A comparison of electrophysiologic testing with Holter monitoring to predict antiarrhythmic-drug efficacy for ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. | journal=N Engl J Med | year= 1993 | volume= 329 | issue= 7 | pages= 445-51 | pmid=8332149 | doi=10.1056/NEJM199308123290701 | pmc= | url= }} &amp;lt;/ref&amp;gt;&amp;lt;ref name=&amp;quot;pmid8332150&amp;quot;&amp;gt;{{cite journal| author=Mason JW| title=A comparison of seven antiarrhythmic drugs in patients with ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. | journal=N Engl J Med | year= 1993 | volume= 329 | issue= 7 | pages= 452-8 | pmid=8332150 | doi=10.1056/NEJM199308123290702 | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: EP testing and Holter monitor of 7 antiarrhythmics (imipramine, mexiletine, procainamide, quinidine, sotalol, pirmenol, propafenone)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  486 patients were randomized and 296 patients were eventually followed up.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 33% in all 296 and 34% in Sotalol group&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  No difference between Holter- and EP-guided groups. Sotalol group had lowest recurrence rate of VT (risk ratio, 0.43; 95 percent confidence interval, 0.29 to 0.62; p&amp;lt;0.001), arrhythmic death (risk ratio, 0.50; 95 percent confidence interval, 0.26 to 0.96; P = 0.04), total death (risk ratio, 0.50; 95 percent confidence interval, 0.30 to 0.80; P = 0.004).&lt;br /&gt;
&lt;br /&gt;
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=== Trials of primary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039; BHAT  ( β-Blocker Heart Attack Trial)&amp;lt;ref name=&amp;quot;pmid7038157&amp;quot;&amp;gt;{{cite journal| author=| title=A randomized trial of propranolol in patients with acute myocardial infarction. I. Mortality results. | journal=JAMA | year= 1982 | volume= 247 | issue= 12 | pages= 1707-14 | pmid=7038157 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039; : multicenter, randomized, double-blind, and placebo-controlled trial designed to test whether the regular administration of propranolol hydrochloride to men and women who had experienced at least one myocardial infarction would result in a significant reduction in total mortality during a two- to four-year period.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 3837, Propanolol: 1916, Placebo: 1921 persons, five to 21 days after the infarction.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Total mortality during the average 25-month follow-up period was 7.2% in the propranolol group and 9.8% in the placebo group. Arteriosclerotic heart disease (ASHD) mortality was 6.2% in the propranolol group and 8.5% in the placebo group. &lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CAST (The Cardiac Arrhythmia Suppression Trial)&amp;lt;ref name=&amp;quot;pmid1900101&amp;quot;&amp;gt;{{cite journal| author=Echt DS, Liebson PR, Mitchell LB, Peters RW, Obias-Manno D, Barker AH et al.| title=Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. | journal=N Engl J Med | year= 1991 | volume= 324 | issue= 12 | pages= 781-8 | pmid=1900101 | doi=10.1056/NEJM199103213241201 | pmc= | url= }} &amp;lt;/ref&amp;gt;&amp;lt;ref name=&amp;quot;pmid1377359&amp;quot;&amp;gt;{{cite journal| author=| title=Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. The Cardiac Arrhythmia Suppression Trial II Investigators. | journal=N Engl J Med | year= 1992 | volume= 327 | issue= 4 | pages= 227-33 | pmid=1377359 | doi=10.1056/NEJM199207233270403 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Suppression of ventricular ectopy after a myocardial infarction reduces the incidence of sudden death, patients in whom ventricular ectopy could be suppressed with encainide, flecainide, or moricizine were randomly assigned to receive either active drug or placebo&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1498 patients,Encainide+Placebo: 857(432 to active drug and 425 to placebo), Flecainide+Placebo: 641 (323 to active drug and 318 to placebo).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 89 patients had died: 59 of arrhythmia (43 receiving drug vs. 16 receiving placebo; P = 0.0004), 22 of nonarrhythmic cardiac causes (17 receiving drug vs. 5 receiving placebo; P = 0.01), and 8 of noncardiac causes (3 receiving drug vs. 5 receiving placebo). Almost all cardiac deaths not due to arrhythmia were attributed to acute myocardial infarction with shock (11 patients receiving drug and 3 receiving placebo) or to chronic congestive heart failure (4 receiving drug and 2 receiving placebo). There were no differences between the patients receiving active drug and those receiving placebo in the incidence of nonlethal disqualifying ventricular tachycardia, proarrhythmia, syncope, need for a permanent pacemaker, congestive heart failure, recurrent myocardial infarction, angina, or need for coronary-artery bypass grafting or angioplasty.&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039; SWORD (The Survival With Oral d-Sotalol trial)&amp;lt;ref name=&amp;quot;pmid8691967&amp;quot;&amp;gt;{{cite journal| author=Waldo AL, Camm AJ, deRuyter H, Friedman PL, MacNeil DJ, Pauls JF et al.| title=Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. The SWORD Investigators. Survival With Oral d-Sotalol. | journal=Lancet | year= 1996 | volume= 348 | issue= 9019 | pages= 7-12 | pmid=8691967 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=8691967  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;:  whether d-sotalol, could reduce all-cause mortality in patients with Left ventricular dysfunction after myocardial infarction .&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 3121, d-Sotalol : 1549, placebo : 1572 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  Mortality : d-sotalol: 78 deaths (5.0%), Placebo: 48 deaths (3.1%) (relative risk 1.65 [95% CI 115–2.36], p=0.006). Presumed arrhythmic deaths (relative risk 1.77 [1.15–2.74], p=0.008). The effect was greater in patients with a left ventricular ejection fraction of 31–40% than in those with lower (≤30%) ejection fractions (relative risk 4.0 vs 1.2, p=0.007).&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;EMIAT (The European Myocardial Infarct Amiodarone Trial)&amp;lt;ref name=&amp;quot;pmid9078197&amp;quot;&amp;gt;{{cite journal| author=Julian DG, Camm AJ, Frangin G, Janse MJ, Munoz A, Schwartz PJ et al.| title=Randomised trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT. European Myocardial Infarct Amiodarone Trial Investigators. | journal=Lancet | year= 1997 | volume= 349 | issue= 9053 | pages= 667-74 | pmid=9078197 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=9078197  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone effect on reduction of mortality in patients of myocardial infarction with impaired ventricular function, irrespective of whether they had ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1486, Amiodarone : 743, Placebo : 743&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone group, there was a 35% risk reduction (95% CI 0–58, p=0.05) in arrhythmic deaths.&lt;br /&gt;
&lt;br /&gt;
6. &#039;&#039;&#039;CAMIAT (The Cardiac Arrhythmia Suppression Trial)&amp;lt;ref name=&amp;quot;pmid9078198&amp;quot;&amp;gt;{{cite journal| author=Cairns JA, Connolly SJ, Roberts R, Gent M| title=Randomised trial of outcome after myocardial infarction in patients with frequent or repetitive ventricular premature depolarisations: CAMIAT. Canadian Amiodarone Myocardial Infarction Arrhythmia Trial Investigators. | journal=Lancet | year= 1997 | volume= 349 | issue= 9053 | pages= 675-82 | pmid=9078198 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=9078198  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess the effect of amiodarone on the risk of resuscitated ventricular fibrillation or arrhythmic death among survivors of myocardial infarction with frequent or repetitive VPDs (≥10 VPDs per h or ≥1 run of ventricular tachycardia).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 1202, Amiodarone :  606, Placebo: 596&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;:&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Analysis: resuscitated ventricular fibrillation or arrhythmic death – Placebo : 31 (6.0%) Amiodarone : 15 (3.3%) (relative-risk reduction 48.5% [95% CI 4.5 to 72.2], p=0.016). Intention-to-treat analysis: primary outcome events Placebo : 24 (6.9%) Amiodarone : 15 (4.5 (38.2% [95% CI –2.1 to 62.6], p=0.029). The absolute-risk reductions were greatest among patients with congestive heart failure or a history of myocardial infarction.&lt;br /&gt;
&lt;br /&gt;
7. &#039;&#039;&#039;GESICA (the Gruppo de Estudo de la Sobrevida en la Insuficiencia Cardiaca en Argentina)&amp;lt;ref name=&amp;quot;pmid8989129&amp;quot;&amp;gt;{{cite journal| author=Doval HC, Nul DR, Grancelli HO, Varini SD, Soifer S, Corrado G et al.| title=Nonsustained ventricular tachycardia in severe heart failure. Independent marker of increased mortality due to sudden death. GESICA-GEMA Investigators. | journal=Circulation | year= 1996 | volume= 94 | issue= 12 | pages= 3198-203 | pmid=8989129 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To determine the prognostic value of nonsustained ventricular tachycardia (NSVT) in total mortality in severe congestive heart failure (CHF) and predictive value of NSVT as a marker for sudden death or death due to progressive heart failure. &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 516, NSVT: 173 (33.5%), No NSVT: and 343 (66.5&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality - NSVT: 87(50.3%) No NSVT: (30.9%) (RR = 1.69 (95% confidence interval [CI], 1.27 to 2.24; P&amp;lt;.0002; Cox proportional hazard analysis was 1.62 (95% CI, 1.22 to 2.16; P&amp;lt;.001)). Sudden death – No NSVT: 8.7%, NSVT: 23.7% (RR, 2.77; 95% CI, 1.78 to 4.44; P&amp;lt;.001). Progressive heart failure death – No NSVT: 17.5%, NSVT: 20.8% (P=.22). Couplets prediction of total all-cause mortality: RR, 1.81; 95% CI, 1.22 to 2.66; P&amp;lt;.002 ; sudden death: RR, 3.37; 95% CI, 1.57 to 7.25; P&amp;lt;.0005. Couplets±NSVT prediction of sudden death: RR, 10.1; 95% CI, 1.91 to 52.7; P&amp;lt;.01.&lt;br /&gt;
&lt;br /&gt;
8. &#039;&#039;&#039;CHF-STAT (Congestive heart failure: Survival trial of antiarrhythmic therapy)&amp;lt;ref name=&amp;quot;pmid7539890&amp;quot;&amp;gt;{{cite journal| author=Singh SN, Fletcher RD, Fisher SG, Singh BN, Lewis HD, Deedwania PC et al.| title=Amiodarone in patients with congestive heart failure and asymptomatic ventricular arrhythmia. Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure. | journal=N Engl J Med | year= 1995 | volume= 333 | issue= 2 | pages= 77-82 | pmid=7539890 | doi=10.1056/NEJM199507133330201 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 674, Amiodarone: 336, Placebo: 338&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: to determine whether Amiodarone can reduce overall mortality in patients with congestive heart failure and asymptomatic ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%, ≥10 PVCs/hr&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: The rate of sudden death was 15% in the Amiodarone group and 19% in the placebo group in Ischemic Cardiomyopathy group (P=0.43). Reduction in overall mortality among the patients with nonischemic cardiomyopathy who received Amiodarone (P =0.07).&lt;br /&gt;
&lt;br /&gt;
9. &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&amp;lt;ref name=&amp;quot;pmid8960472&amp;quot;&amp;gt;{{cite journal| author=Moss AJ, Hall WJ, Cannom DS, Daubert JP, Higgins SL, Klein H et al.| title=Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators. | journal=N Engl J Med | year= 1996 | volume= 335 | issue= 26 | pages= 1933-40 | pmid=8960472 | doi=10.1056/NEJM199612263352601 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
10. &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&amp;lt;ref name=&amp;quot;pmid10086963&amp;quot;&amp;gt;{{cite journal| author=Bigger JT, Whang W, Rottman JN, Kleiger RE, Gottlieb CD, Namerow PB et al.| title=Mechanisms of death in the CABG Patch trial: a randomized trial of implantable cardiac defibrillator prophylaxis in patients at high risk of death after coronary artery bypass graft surgery. | journal=Circulation | year= 1999 | volume= 99 | issue= 11 | pages= 1416-21 | pmid=10086963 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
11. &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&amp;lt;ref name=&amp;quot;pmid12767651&amp;quot;&amp;gt;{{cite journal| author=Strickberger SA, Hummel JD, Bartlett TG, Frumin HI, Schuger CD, Beau SL et al.| title=Amiodarone versus implantable cardioverter-defibrillator:randomized trial in patients with nonischemic dilated cardiomyopathy and asymptomatic nonsustained ventricular tachycardia--AMIOVIRT. | journal=J Am Coll Cardiol | year= 2003 | volume= 41 | issue= 10 | pages= 1707-12 | pmid=12767651 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=12767651  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
12. &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&amp;lt;ref name=&amp;quot;pmid15152060&amp;quot;&amp;gt;{{cite journal| author=Kadish A, Dyer A, Daubert JP, Quigg R, Estes NA, Anderson KP et al.| title=Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. | journal=N Engl J Med | year= 2004 | volume= 350 | issue= 21 | pages= 2151-8 | pmid=15152060 | doi=10.1056/NEJMoa033088 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15152060  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15518445 Review in: ACP J Club. 2004 Nov-Dec;141(3):61] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
13. &#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&amp;lt;ref name=&amp;quot;pmid15590950&amp;quot;&amp;gt;{{cite journal| author=Hohnloser SH, Kuck KH, Dorian P, Roberts RS, Hampton JR, Hatala R et al.| title=Prophylactic use of an implantable cardioverter-defibrillator after acute myocardial infarction. | journal=N Engl J Med | year= 2004 | volume= 351 | issue= 24 | pages= 2481-8 | pmid=15590950 | doi=10.1056/NEJMoa041489 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15590950  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15862057 Review in: ACP J Club. 2005 May-Jun;142(3):58] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
14. &#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&amp;lt;ref name=&amp;quot;pmid15659722&amp;quot;&amp;gt;{{cite journal| author=Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, Boineau R et al.| title=Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. | journal=N Engl J Med | year= 2005 | volume= 352 | issue= 3 | pages= 225-37 | pmid=15659722 | doi=10.1056/NEJMoa043399 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15659722  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15989294 Review in: ACP J Club. 2005 Jul-Aug;143(1):6] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
15. &#039;&#039;&#039;MUSTT (the Multicenter Unsustained Tachycardia Trial)&amp;lt;ref name=&amp;quot;pmid10601507&amp;quot;&amp;gt;{{cite journal| author=Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EN, Hafley G| title=A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators. | journal=N Engl J Med | year= 1999 | volume= 341 | issue= 25 | pages= 1882-90 | pmid=10601507 | doi=10.1056/NEJM199912163412503 | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Electrophysiologically guided antiarrhythmic therapy would reduce the risk of sudden death among patients with coronary artery disease, a left ventricular ejection fraction of 40 percent or less, and asymptomatic, unsustained ventricular tachycardia&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: 704 patients who underwent randomization, 351 were assigned to receive electrophysiologically guided therapy and 353 were assigned to receive no antiarrhythmic therapy.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: LVEF &amp;lt;40% + NSVT&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study:  Cardiac Arrest or Death from Arrhythmia - EP guided therapy = 25% no antiarrhythmic therapy = 32% (RR=0.73, CI=0.53-0.99). Cardiac arrest or death from arrhythmia - Treatment with Defibrillators vs w/o Defibrillator Treatment (RR=0.24; CI=0.13-0.45; P&amp;lt;0.001). &lt;br /&gt;
&lt;br /&gt;
16. &#039;&#039;&#039;MADIT II (Multicenter Automatic Defibrillator Implantation Trial - II)&amp;lt;ref name=&amp;quot;pmid11907286&amp;quot;&amp;gt;{{cite journal| author=Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS et al.| title=Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. | journal=N Engl J Med | year= 2002 | volume= 346 | issue= 12 | pages= 877-83 | pmid=11907286 | doi=10.1056/NEJMoa013474 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=11907286  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=12418821 Review in: ACP J Club. 2002 Nov-Dec;137(3):81] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To evaluate the effect of an implantable defibrillator on survival in patients with reduced left ventricular function after myocardial infarction are at risk for life threatening ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1232, ICD: 742, Conventional Medical Therapy: 490 patients&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤30% &amp;gt;10 PVCs/hr or couplets&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality – Conventional Medical Therapy: 19.8%, ICD: 14.2%(HR 0.69 (95 CI= 0.51-0.93, P=0.016).&lt;br /&gt;
&lt;br /&gt;
17. &#039;&#039;&#039;COMPANION (The Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure trial )&amp;lt;ref name=&amp;quot;pmid15152059&amp;quot;&amp;gt;{{cite journal| author=Bristow MR, Saxon LA, Boehmer J, Krueger S, Kass DA, De Marco T et al.| title=Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. | journal=N Engl J Med | year= 2004 | volume= 350 | issue= 21 | pages= 2140-50 | pmid=15152059 | doi=10.1056/NEJMoa032423 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15152059  }}  [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=15518444 Review in: ACP J Club. 2004 Nov-Dec;141(3):60] &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Prophylactic cardiac-resynchronization therapy in the form of biventricular stimulation with a pacemaker with or without a defibrillator would reduce the risk of death and hospitalization among patients with advanced chronic heart failure and intraventricular conduction delays.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1520, Optimal Pharmacologic Therapy: 308, Cardiac- Resynchronization Therapy:  Pacemaker=617, Pacemaker– Defibrillator=595&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: Ischemic or nonischemic CM NYHA Class III-IV QRS ≥120 msec&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Pacemaker group - Primary end point mortality reduction (hazard ratio, 0.81; P=0.014), Pacemaker–defibrillator group (hazard ratio, 0.80; P=0.01). Primary end point mortality reduction: 34% - Pacemaker group (P&amp;lt;0.002), 40% - Pacemaker–Defibrillator group (P&amp;lt;0.001). Secondary end point mortality reduction: 24% - Pacemaker group (P=0.059), 36% - Pacemaker–Defibrillator group (P=0.003). &lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
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{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=620315</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=620315"/>
		<updated>2012-01-12T22:37:31Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&amp;lt;ref name=&amp;quot;pmid9411221&amp;quot;&amp;gt;{{cite journal| author=| title=A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. The Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators. | journal=N Engl J Med | year= 1997 | volume= 337 | issue= 22 | pages= 1576-83 | pmid=9411221 | doi=10.1056/NEJM199711273372202 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&amp;lt;ref name=&amp;quot;pmid10725290&amp;quot;&amp;gt;{{cite journal| author=Connolly SJ, Gent M, Roberts RS, Dorian P, Roy D, Sheldon RS et al.| title=Canadian implantable defibrillator study (CIDS) : a randomized trial of the implantable cardioverter defibrillator against amiodarone. | journal=Circulation | year= 2000 | volume= 101 | issue= 11 | pages= 1297-302 | pmid=10725290 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&amp;lt;ref name=&amp;quot;pmid10942742&amp;quot;&amp;gt;{{cite journal| author=Kuck KH, Cappato R, Siebels J, Rüppel R| title=Randomized comparison of antiarrhythmic drug therapy with implantable defibrillators in patients resuscitated from cardiac arrest : the Cardiac Arrest Study Hamburg (CASH). | journal=Circulation | year= 2000 | volume= 102 | issue= 7 | pages= 748-54 | pmid=10942742 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CASCADE(The Cardiac Arrest in Seatle Conventional Versus Amiodarone Drug Evaluation study)&amp;lt;ref name=&amp;quot;pmid8237833&amp;quot;&amp;gt;{{cite journal| author=Greene HL| title=The CASCADE Study: randomized antiarrhythmic drug therapy in survivors of cardiac arrest in Seattle. CASCADE Investigators. | journal=Am J Cardiol | year= 1993 | volume= 72 | issue= 16 | pages= 70F-74F | pmid=8237833 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone vs conventional therapy in patients with/without AICD&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 228 Amiodarone: 113 conventional antiarrhythmic drugs: 115(quinidine (n=33), procainamide (n = 26), combination therapy (n = 17), flecainide (n = 12). AICD: 105 (Amiodarone: 53, Conventional therapy: 52)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 13% more survival in patient population at the primary end point (total cardiac mortality, resuscitated cardiac arrest due to ventricular fibrillation, and syncopal Implanted defibrillator shocks) at the end of 6 years. (p=0.007).  With AICD 16% survival more at the primary end point( shocks preceded by complete syncope)(p=0.032) conclusively showing superiority of Amidarone over convetional therapy in secondary prevention.&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039; ESVEM (Electrophysiologic Study Versus Electrocardiographic Monitoring for Selection of Antiarrhythmic Therapy of Ventricular Tachyarrhythmias)&amp;lt;ref name=&amp;quot;pmid8332149&amp;quot;&amp;gt;{{cite journal| author=Mason JW| title=A comparison of electrophysiologic testing with Holter monitoring to predict antiarrhythmic-drug efficacy for ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. | journal=N Engl J Med | year= 1993 | volume= 329 | issue= 7 | pages= 445-51 | pmid=8332149 | doi=10.1056/NEJM199308123290701 | pmc= | url= }} &amp;lt;/ref&amp;gt;&amp;lt;ref name=&amp;quot;pmid8332150&amp;quot;&amp;gt;{{cite journal| author=Mason JW| title=A comparison of seven antiarrhythmic drugs in patients with ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. | journal=N Engl J Med | year= 1993 | volume= 329 | issue= 7 | pages= 452-8 | pmid=8332150 | doi=10.1056/NEJM199308123290702 | pmc= | url= }} &amp;lt;/ref&amp;gt; &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: EP testing and Holter monitor of 7 antiarrhythmics (imipramine, mexiletine, procainamide, quinidine, sotalol, pirmenol, propafenone)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  486 patients were randomized and 296 patients were eventually followed up.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 33% in all 296 and 34% in Sotalol group&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  No difference between Holter- and EP-guided groups. Sotalol group had lowest recurrence rate of VT (risk ratio, 0.43; 95 percent confidence interval, 0.29 to 0.62; p&amp;lt;0.001), arrhythmic death (risk ratio, 0.50; 95 percent confidence interval, 0.26 to 0.96; P = 0.04), total death (risk ratio, 0.50; 95 percent confidence interval, 0.30 to 0.80; P = 0.004).&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039; BHAT  ( β-Blocker Heart Attack Trial)&amp;lt;ref name=&amp;quot;pmid7038157&amp;quot;&amp;gt;{{cite journal| author=| title=A randomized trial of propranolol in patients with acute myocardial infarction. I. Mortality results. | journal=JAMA | year= 1982 | volume= 247 | issue= 12 | pages= 1707-14 | pmid=7038157 | doi= | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039; : multicenter, randomized, double-blind, and placebo-controlled trial designed to test whether the regular administration of propranolol hydrochloride to men and women who had experienced at least one myocardial infarction would result in a significant reduction in total mortality during a two- to four-year period.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 3837, Propanolol: 1916, Placebo: 1921 persons, five to 21 days after the infarction.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Total mortality during the average 25-month follow-up period was 7.2% in the propranolol group and 9.8% in the placebo group. Arteriosclerotic heart disease (ASHD) mortality was 6.2% in the propranolol group and 8.5% in the placebo group. &lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CAST (The Cardiac Arrhythmia Suppression Trial)&amp;lt;ref name=&amp;quot;pmid1900101&amp;quot;&amp;gt;{{cite journal| author=Echt DS, Liebson PR, Mitchell LB, Peters RW, Obias-Manno D, Barker AH et al.| title=Mortality and morbidity in patients receiving encainide, flecainide, or placebo. The Cardiac Arrhythmia Suppression Trial. | journal=N Engl J Med | year= 1991 | volume= 324 | issue= 12 | pages= 781-8 | pmid=1900101 | doi=10.1056/NEJM199103213241201 | pmc= | url= }} &amp;lt;/ref&amp;gt;&amp;lt;ref name=&amp;quot;pmid1377359&amp;quot;&amp;gt;{{cite journal| author=| title=Effect of the antiarrhythmic agent moricizine on survival after myocardial infarction. The Cardiac Arrhythmia Suppression Trial II Investigators. | journal=N Engl J Med | year= 1992 | volume= 327 | issue= 4 | pages= 227-33 | pmid=1377359 | doi=10.1056/NEJM199207233270403 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Suppression of ventricular ectopy after a myocardial infarction reduces the incidence of sudden death, patients in whom ventricular ectopy could be suppressed with encainide, flecainide, or moricizine were randomly assigned to receive either active drug or placebo&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1498 patients,Encainide+Placebo: 857(432 to active drug and 425 to placebo), Flecainide+Placebo: 641 (323 to active drug and 318 to placebo).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 89 patients had died: 59 of arrhythmia (43 receiving drug vs. 16 receiving placebo; P = 0.0004), 22 of nonarrhythmic cardiac causes (17 receiving drug vs. 5 receiving placebo; P = 0.01), and 8 of noncardiac causes (3 receiving drug vs. 5 receiving placebo). Almost all cardiac deaths not due to arrhythmia were attributed to acute myocardial infarction with shock (11 patients receiving drug and 3 receiving placebo) or to chronic congestive heart failure (4 receiving drug and 2 receiving placebo). There were no differences between the patients receiving active drug and those receiving placebo in the incidence of nonlethal disqualifying ventricular tachycardia, proarrhythmia, syncope, need for a permanent pacemaker, congestive heart failure, recurrent myocardial infarction, angina, or need for coronary-artery bypass grafting or angioplasty.&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039; SWORD (The Survival With Oral d-Sotalol trial)&amp;lt;ref name=&amp;quot;pmid8691967&amp;quot;&amp;gt;{{cite journal| author=Waldo AL, Camm AJ, deRuyter H, Friedman PL, MacNeil DJ, Pauls JF et al.| title=Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. The SWORD Investigators. Survival With Oral d-Sotalol. | journal=Lancet | year= 1996 | volume= 348 | issue= 9019 | pages= 7-12 | pmid=8691967 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&amp;amp;tool=sumsearch.org/cite&amp;amp;retmode=ref&amp;amp;cmd=prlinks&amp;amp;id=8691967  }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;:  whether d-sotalol, could reduce all-cause mortality in patients with Left ventricular dysfunction after myocardial infarction .&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 3121, d-Sotalol : 1549, placebo : 1572 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  Mortality : d-sotalol: 78 deaths (5.0%), Placebo: 48 deaths (3.1%) (relative risk 1.65 [95% CI 115–2.36], p=0.006). Presumed arrhythmic deaths (relative risk 1.77 [1.15–2.74], p=0.008). The effect was greater in patients with a left ventricular ejection fraction of 31–40% than in those with lower (≤30%) ejection fractions (relative risk 4.0 vs 1.2, p=0.007).&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;EMIAT (The European Myocardial Infarct Amiodarone Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone effect on reduction of mortality in patients of myocardial infarction with impaired ventricular function, irrespective of whether they had ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1486, Amiodarone : 743, Placebo : 743&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone group, there was a 35% risk reduction (95% CI 0–58, p=0.05) in arrhythmic deaths.&lt;br /&gt;
&lt;br /&gt;
6. &#039;&#039;&#039;CAMIAT (The Cardiac Arrhythmia Suppression Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess the effect of amiodarone on the risk of resuscitated ventricular fibrillation or arrhythmic death among survivors of myocardial infarction with frequent or repetitive VPDs (≥10 VPDs per h or ≥1 run of ventricular tachycardia).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 1202, Amiodarone :  606, Placebo: 596&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;:&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Analysis: resuscitated ventricular fibrillation or arrhythmic death – Placebo : 31 (6.0%) Amiodarone : 15 (3.3%) (relative-risk reduction 48.5% [95% CI 4.5 to 72.2], p=0.016). Intention-to-treat analysis: primary outcome events Placebo : 24 (6.9%) Amiodarone : 15 (4.5 (38.2% [95% CI –2.1 to 62.6], p=0.029). The absolute-risk reductions were greatest among patients with congestive heart failure or a history of myocardial infarction.&lt;br /&gt;
&lt;br /&gt;
7. &#039;&#039;&#039;GESICA (the Gruppo de Estudo de la Sobrevida en la Insuficiencia Cardiaca en Argentina)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To determine the prognostic value of nonsustained ventricular tachycardia (NSVT) in total mortality in severe congestive heart failure (CHF) and predictive value of NSVT as a marker for sudden death or death due to progressive heart failure. &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 516, NSVT: 173 (33.5%), No NSVT: and 343 (66.5&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality - NSVT: 87(50.3%) No NSVT: (30.9%) (RR = 1.69 (95% confidence interval [CI], 1.27 to 2.24; P&amp;lt;.0002; Cox proportional hazard analysis was 1.62 (95% CI, 1.22 to 2.16; P&amp;lt;.001)). Sudden death – No NSVT: 8.7%, NSVT: 23.7% (RR, 2.77; 95% CI, 1.78 to 4.44; P&amp;lt;.001). Progressive heart failure death – No NSVT: 17.5%, NSVT: 20.8% (P=.22). Couplets prediction of total all-cause mortality: RR, 1.81; 95% CI, 1.22 to 2.66; P&amp;lt;.002 ; sudden death: RR, 3.37; 95% CI, 1.57 to 7.25; P&amp;lt;.0005. Couplets±NSVT prediction of sudden death: RR, 10.1; 95% CI, 1.91 to 52.7; P&amp;lt;.01.&lt;br /&gt;
&lt;br /&gt;
8. &#039;&#039;&#039;CHF-STAT (Congestive heart failure: Survival trial of antiarrhythmic therapy)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 674, Amiodarone: 336, Placebo: 338&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: to determine whether Amiodarone can reduce overall mortality in patients with congestive heart failure and asymptomatic ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%, ≥10 PVCs/hr&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: The rate of sudden death was 15% in the Amiodarone group and 19% in the placebo group in Ischemic Cardiomyopathy group (P=0.43). Reduction in overall mortality among the patients with nonischemic cardiomyopathy who received Amiodarone (P =0.07).&lt;br /&gt;
&lt;br /&gt;
9. &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
10. &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
11. &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
12. &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
13. &#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
14. &#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
15. &#039;&#039;&#039;MUSTT (the Multicenter Unsustained Tachycardia Trial) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Electrophysiologically guided antiarrhythmic therapy would reduce the risk of sudden death among patients with coronary artery disease, a left ventricular ejection fraction of 40 percent or less, and asymptomatic, unsustained ventricular tachycardia&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: 704 patients who underwent randomization, 351 were assigned to receive electrophysiologically guided therapy and 353 were assigned to receive no antiarrhythmic therapy.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: LVEF &amp;lt;40% + NSVT&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study:  Cardiac Arrest or Death from Arrhythmia - EP guided therapy = 25% no antiarrhythmic therapy = 32% (RR=0.73, CI=0.53-0.99). Cardiac arrest or death from arrhythmia - Treatment with Defibrillators vs w/o Defibrillator Treatment (RR=0.24; CI=0.13-0.45; P&amp;lt;0.001). &lt;br /&gt;
&lt;br /&gt;
16. &#039;&#039;&#039;MADIT II (Multicenter Automatic Defibrillator Implantation Trial - II) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To evaluate the effect of an implantable defibrillator on survival in patients with reduced left ventricular function after myocardial infarction are at risk for life threatening ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1232, ICD: 742, Conventional Medical Therapy: 490 patients&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤30% &amp;gt;10 PVCs/hr or couplets&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality – Conventional Medical Therapy: 19.8%, ICD: 14.2%(HR 0.69 (95 CI= 0.51-0.93, P=0.016).&lt;br /&gt;
&lt;br /&gt;
17. &#039;&#039;&#039;COMPANION (The Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure trial )&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Prophylactic cardiac-resynchronization therapy in the form of biventricular stimulation with a pacemaker with or without a defibrillator would reduce the risk of death and hospitalization among patients with advanced chronic heart failure and intraventricular conduction delays.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1520, Optimal Pharmacologic Therapy: 308, Cardiac- Resynchronization Therapy:  Pacemaker=617, Pacemaker– Defibrillator=595&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: Ischemic or nonischemic CM NYHA Class III-IV QRS ≥120 msec&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Pacemaker group - Primary end point mortality reduction (hazard ratio, 0.81; P=0.014), Pacemaker–defibrillator group (hazard ratio, 0.80; P=0.01). Primary end point mortality reduction: 34% - Pacemaker group (P&amp;lt;0.002), 40% - Pacemaker–Defibrillator group (P&amp;lt;0.001). Secondary end point mortality reduction: 24% - Pacemaker group (P=0.059), 36% - Pacemaker–Defibrillator group (P=0.003). &lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=620313</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=620313"/>
		<updated>2012-01-12T22:22:18Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&amp;lt;ref name=&amp;quot;pmid9411221&amp;quot;&amp;gt;{{cite journal| author=| title=A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. The Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators. | journal=N Engl J Med | year= 1997 | volume= 337 | issue= 22 | pages= 1576-83 | pmid=9411221 | doi=10.1056/NEJM199711273372202 | pmc= | url= }} &amp;lt;/ref&amp;gt;&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CASCADE(The Cardiac Arrest in Seatle Conventional Versus Amiodarone Drug Evaluation study) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone vs conventional therapy in patients with/without AICD&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 228 Amiodarone: 113 conventional antiarrhythmic drugs: 115(quinidine (n=33), procainamide (n = 26), combination therapy (n = 17), flecainide (n = 12). AICD: 105 (Amiodarone: 53, Conventional therapy: 52)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 13% more survival in patient population at the primary end point (total cardiac mortality, resuscitated cardiac arrest due to ventricular fibrillation, and syncopal Implanted defibrillator shocks) at the end of 6 years. (p=0.007).  With AICD 16% survival more at the primary end point( shocks preceded by complete syncope)(p=0.032) conclusively showing superiority of Amidarone over convetional therapy in secondary prevention.&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039; ESVEM (Electrophysiologic Study Versus Electrocardiographic Monitoring for Selection of Antiarrhythmic Therapy of Ventricular Tachyarrhythmias) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: EP testing and Holter monitor of 7 antiarrhythmics (imipramine, mexiletine, procainamide, quinidine, sotalol, pirmenol, propafenone)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  486 patients were randomized and 296 patients were eventually followed up.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 33% in all 296 and 34% in Sotalol group&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  No difference between Holter- and EP-guided groups. Sotalol group had lowest recurrence rate of VT (risk ratio, 0.43; 95 percent confidence interval, 0.29 to 0.62; p&amp;lt;0.001), arrhythmic death (risk ratio, 0.50; 95 percent confidence interval, 0.26 to 0.96; P = 0.04), total death (risk ratio, 0.50; 95 percent confidence interval, 0.30 to 0.80; P = 0.004).&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039; BHAT  ( β-Blocker Heart Attack Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039; : multicenter, randomized, double-blind, and placebo-controlled trial designed to test whether the regular administration of propranolol hydrochloride to men and women who had experienced at least one myocardial infarction would result in a significant reduction in total mortality during a two- to four-year period.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 3837, Propanolol: 1916, Placebo: 1921 persons, five to 21 days after the infarction.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Total mortality during the average 25-month follow-up period was 7.2% in the propranolol group and 9.8% in the placebo group. Arteriosclerotic heart disease (ASHD) mortality was 6.2% in the propranolol group and 8.5% in the placebo group. &lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CAST (The Cardiac Arrhythmia Suppression Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Suppression of ventricular ectopy after a myocardial infarction reduces the incidence of sudden death, patients in whom ventricular ectopy could be suppressed with encainide, flecainide, or moricizine were randomly assigned to receive either active drug or placebo&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1498 patients,Encainide+Placebo: 857(432 to active drug and 425 to placebo), Flecainide+Placebo: 641 (323 to active drug and 318 to placebo).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 89 patients had died: 59 of arrhythmia (43 receiving drug vs. 16 receiving placebo; P = 0.0004), 22 of nonarrhythmic cardiac causes (17 receiving drug vs. 5 receiving placebo; P = 0.01), and 8 of noncardiac causes (3 receiving drug vs. 5 receiving placebo). Almost all cardiac deaths not due to arrhythmia were attributed to acute myocardial infarction with shock (11 patients receiving drug and 3 receiving placebo) or to chronic congestive heart failure (4 receiving drug and 2 receiving placebo). There were no differences between the patients receiving active drug and those receiving placebo in the incidence of nonlethal disqualifying ventricular tachycardia, proarrhythmia, syncope, need for a permanent pacemaker, congestive heart failure, recurrent myocardial infarction, angina, or need for coronary-artery bypass grafting or angioplasty.&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039; SWORD (The Survival With Oral d-Sotalol (SWORD) trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;:  whether d-sotalol, could reduce all-cause mortality in patients with Left ventricular dysfunction after myocardial infarction .&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 3121, d-Sotalol : 1549, placebo : 1572 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  Mortality : d-sotalol: 78 deaths (5.0%), Placebo: 48 deaths (3.1%) (relative risk 1.65 [95% CI 115–2.36], p=0.006). Presumed arrhythmic deaths (relative risk 1.77 [1.15–2.74], p=0.008). The effect was greater in patients with a left ventricular ejection fraction of 31–40% than in those with lower (≤30%) ejection fractions (relative risk 4.0 vs 1.2, p=0.007).&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;EMIAT (The European Myocardial Infarct Amiodarone Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone effect on reduction of mortality in patients of myocardial infarction with impaired ventricular function, irrespective of whether they had ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1486, Amiodarone : 743, Placebo : 743&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone group, there was a 35% risk reduction (95% CI 0–58, p=0.05) in arrhythmic deaths.&lt;br /&gt;
&lt;br /&gt;
6. &#039;&#039;&#039;CAMIAT (The Cardiac Arrhythmia Suppression Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess the effect of amiodarone on the risk of resuscitated ventricular fibrillation or arrhythmic death among survivors of myocardial infarction with frequent or repetitive VPDs (≥10 VPDs per h or ≥1 run of ventricular tachycardia).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 1202, Amiodarone :  606, Placebo: 596&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;:&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Analysis: resuscitated ventricular fibrillation or arrhythmic death – Placebo : 31 (6.0%) Amiodarone : 15 (3.3%) (relative-risk reduction 48.5% [95% CI 4.5 to 72.2], p=0.016). Intention-to-treat analysis: primary outcome events Placebo : 24 (6.9%) Amiodarone : 15 (4.5 (38.2% [95% CI –2.1 to 62.6], p=0.029). The absolute-risk reductions were greatest among patients with congestive heart failure or a history of myocardial infarction.&lt;br /&gt;
&lt;br /&gt;
7. &#039;&#039;&#039;GESICA (the Gruppo de Estudo de la Sobrevida en la Insuficiencia Cardiaca en Argentina)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To determine the prognostic value of nonsustained ventricular tachycardia (NSVT) in total mortality in severe congestive heart failure (CHF) and predictive value of NSVT as a marker for sudden death or death due to progressive heart failure. &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 516, NSVT: 173 (33.5%), No NSVT: and 343 (66.5&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality - NSVT: 87(50.3%) No NSVT: (30.9%) (RR = 1.69 (95% confidence interval [CI], 1.27 to 2.24; P&amp;lt;.0002; Cox proportional hazard analysis was 1.62 (95% CI, 1.22 to 2.16; P&amp;lt;.001)). Sudden death – No NSVT: 8.7%, NSVT: 23.7% (RR, 2.77; 95% CI, 1.78 to 4.44; P&amp;lt;.001). Progressive heart failure death – No NSVT: 17.5%, NSVT: 20.8% (P=.22). Couplets prediction of total all-cause mortality: RR, 1.81; 95% CI, 1.22 to 2.66; P&amp;lt;.002 ; sudden death: RR, 3.37; 95% CI, 1.57 to 7.25; P&amp;lt;.0005. Couplets±NSVT prediction of sudden death: RR, 10.1; 95% CI, 1.91 to 52.7; P&amp;lt;.01.&lt;br /&gt;
&lt;br /&gt;
8. &#039;&#039;&#039;CHF-STAT (Congestive heart failure: Survival trial of antiarrhythmic therapy)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 674, Amiodarone: 336, Placebo: 338&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: to determine whether Amiodarone can reduce overall mortality in patients with congestive heart failure and asymptomatic ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%, ≥10 PVCs/hr&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: The rate of sudden death was 15% in the Amiodarone group and 19% in the placebo group in Ischemic Cardiomyopathy group (P=0.43). Reduction in overall mortality among the patients with nonischemic cardiomyopathy who received Amiodarone (P =0.07).&lt;br /&gt;
&lt;br /&gt;
9. &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
10. &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
11. &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
12. &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
13. &#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
14. &#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
15. &#039;&#039;&#039;MUSTT (the Multicenter Unsustained Tachycardia Trial) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Electrophysiologically guided antiarrhythmic therapy would reduce the risk of sudden death among patients with coronary artery disease, a left ventricular ejection fraction of 40 percent or less, and asymptomatic, unsustained ventricular tachycardia&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: 704 patients who underwent randomization, 351 were assigned to receive electrophysiologically guided therapy and 353 were assigned to receive no antiarrhythmic therapy.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: LVEF &amp;lt;40% + NSVT&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study:  Cardiac Arrest or Death from Arrhythmia - EP guided therapy = 25% no antiarrhythmic therapy = 32% (RR=0.73, CI=0.53-0.99). Cardiac arrest or death from arrhythmia - Treatment with Defibrillators vs w/o Defibrillator Treatment (RR=0.24; CI=0.13-0.45; P&amp;lt;0.001). &lt;br /&gt;
&lt;br /&gt;
16. &#039;&#039;&#039;MADIT II (Multicenter Automatic Defibrillator Implantation Trial - II) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To evaluate the effect of an implantable defibrillator on survival in patients with reduced left ventricular function after myocardial infarction are at risk for life threatening ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1232, ICD: 742, Conventional Medical Therapy: 490 patients&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤30% &amp;gt;10 PVCs/hr or couplets&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality – Conventional Medical Therapy: 19.8%, ICD: 14.2%(HR 0.69 (95 CI= 0.51-0.93, P=0.016).&lt;br /&gt;
&lt;br /&gt;
17. &#039;&#039;&#039;COMPANION (The Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure trial )&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Prophylactic cardiac-resynchronization therapy in the form of biventricular stimulation with a pacemaker with or without a defibrillator would reduce the risk of death and hospitalization among patients with advanced chronic heart failure and intraventricular conduction delays.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1520, Optimal Pharmacologic Therapy: 308, Cardiac- Resynchronization Therapy:  Pacemaker=617, Pacemaker– Defibrillator=595&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: Ischemic or nonischemic CM NYHA Class III-IV QRS ≥120 msec&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Pacemaker group - Primary end point mortality reduction (hazard ratio, 0.81; P=0.014), Pacemaker–defibrillator group (hazard ratio, 0.80; P=0.01). Primary end point mortality reduction: 34% - Pacemaker group (P&amp;lt;0.002), 40% - Pacemaker–Defibrillator group (P&amp;lt;0.001). Secondary end point mortality reduction: 24% - Pacemaker group (P=0.059), 36% - Pacemaker–Defibrillator group (P=0.003). &lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
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{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=619648</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=619648"/>
		<updated>2011-12-28T20:32:20Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CASCADE(The Cardiac Arrest in Seatle Conventional Versus Amiodarone Drug Evaluation study) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone vs conventional therapy in patients with/without AICD&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 228 Amiodarone: 113 conventional antiarrhythmic drugs: 115(quinidine (n=33), procainamide (n = 26), combination therapy (n = 17), flecainide (n = 12). AICD: 105 (Amiodarone: 53, Conventional therapy: 52)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 13% more survival in patient population at the primary end point (total cardiac mortality, resuscitated cardiac arrest due to ventricular fibrillation, and syncopal Implanted defibrillator shocks) at the end of 6 years. (p=0.007).  With AICD 16% survival more at the primary end point( shocks preceded by complete syncope)(p=0.032) conclusively showing superiority of Amidarone over convetional therapy in secondary prevention.&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039; ESVEM (Electrophysiologic Study Versus Electrocardiographic Monitoring for Selection of Antiarrhythmic Therapy of Ventricular Tachyarrhythmias) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: EP testing and Holter monitor of 7 antiarrhythmics (imipramine, mexiletine, procainamide, quinidine, sotalol, pirmenol, propafenone)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  486 patients were randomized and 296 patients were eventually followed up.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 33% in all 296 and 34% in Sotalol group&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  No difference between Holter- and EP-guided groups. Sotalol group had lowest recurrence rate of VT (risk ratio, 0.43; 95 percent confidence interval, 0.29 to 0.62; p&amp;lt;0.001), arrhythmic death (risk ratio, 0.50; 95 percent confidence interval, 0.26 to 0.96; P = 0.04), total death (risk ratio, 0.50; 95 percent confidence interval, 0.30 to 0.80; P = 0.004).&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039; BHAT  ( β-Blocker Heart Attack Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039; : multicenter, randomized, double-blind, and placebo-controlled trial designed to test whether the regular administration of propranolol hydrochloride to men and women who had experienced at least one myocardial infarction would result in a significant reduction in total mortality during a two- to four-year period.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 3837, Propanolol: 1916, Placebo: 1921 persons, five to 21 days after the infarction.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Total mortality during the average 25-month follow-up period was 7.2% in the propranolol group and 9.8% in the placebo group. Arteriosclerotic heart disease (ASHD) mortality was 6.2% in the propranolol group and 8.5% in the placebo group. &lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CAST (The Cardiac Arrhythmia Suppression Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Suppression of ventricular ectopy after a myocardial infarction reduces the incidence of sudden death, patients in whom ventricular ectopy could be suppressed with encainide, flecainide, or moricizine were randomly assigned to receive either active drug or placebo&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1498 patients,Encainide+Placebo: 857(432 to active drug and 425 to placebo), Flecainide+Placebo: 641 (323 to active drug and 318 to placebo).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 89 patients had died: 59 of arrhythmia (43 receiving drug vs. 16 receiving placebo; P = 0.0004), 22 of nonarrhythmic cardiac causes (17 receiving drug vs. 5 receiving placebo; P = 0.01), and 8 of noncardiac causes (3 receiving drug vs. 5 receiving placebo). Almost all cardiac deaths not due to arrhythmia were attributed to acute myocardial infarction with shock (11 patients receiving drug and 3 receiving placebo) or to chronic congestive heart failure (4 receiving drug and 2 receiving placebo). There were no differences between the patients receiving active drug and those receiving placebo in the incidence of nonlethal disqualifying ventricular tachycardia, proarrhythmia, syncope, need for a permanent pacemaker, congestive heart failure, recurrent myocardial infarction, angina, or need for coronary-artery bypass grafting or angioplasty.&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039; SWORD (The Survival With Oral d-Sotalol (SWORD) trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;:  whether d-sotalol, could reduce all-cause mortality in patients with Left ventricular dysfunction after myocardial infarction .&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 3121, d-Sotalol : 1549, placebo : 1572 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  Mortality : d-sotalol: 78 deaths (5.0%), Placebo: 48 deaths (3.1%) (relative risk 1.65 [95% CI 115–2.36], p=0.006). Presumed arrhythmic deaths (relative risk 1.77 [1.15–2.74], p=0.008). The effect was greater in patients with a left ventricular ejection fraction of 31–40% than in those with lower (≤30%) ejection fractions (relative risk 4.0 vs 1.2, p=0.007).&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;EMIAT (The European Myocardial Infarct Amiodarone Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone effect on reduction of mortality in patients of myocardial infarction with impaired ventricular function, irrespective of whether they had ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1486, Amiodarone : 743, Placebo : 743&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone group, there was a 35% risk reduction (95% CI 0–58, p=0.05) in arrhythmic deaths.&lt;br /&gt;
&lt;br /&gt;
6. &#039;&#039;&#039;CAMIAT (The Cardiac Arrhythmia Suppression Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess the effect of amiodarone on the risk of resuscitated ventricular fibrillation or arrhythmic death among survivors of myocardial infarction with frequent or repetitive VPDs (≥10 VPDs per h or ≥1 run of ventricular tachycardia).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 1202, Amiodarone :  606, Placebo: 596&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;:&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Analysis: resuscitated ventricular fibrillation or arrhythmic death – Placebo : 31 (6.0%) Amiodarone : 15 (3.3%) (relative-risk reduction 48.5% [95% CI 4.5 to 72.2], p=0.016). Intention-to-treat analysis: primary outcome events Placebo : 24 (6.9%) Amiodarone : 15 (4.5 (38.2% [95% CI –2.1 to 62.6], p=0.029). The absolute-risk reductions were greatest among patients with congestive heart failure or a history of myocardial infarction.&lt;br /&gt;
&lt;br /&gt;
7. &#039;&#039;&#039;GESICA (the Gruppo de Estudo de la Sobrevida en la Insuficiencia Cardiaca en Argentina)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To determine the prognostic value of nonsustained ventricular tachycardia (NSVT) in total mortality in severe congestive heart failure (CHF) and predictive value of NSVT as a marker for sudden death or death due to progressive heart failure. &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 516, NSVT: 173 (33.5%), No NSVT: and 343 (66.5&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality - NSVT: 87(50.3%) No NSVT: (30.9%) (RR = 1.69 (95% confidence interval [CI], 1.27 to 2.24; P&amp;lt;.0002; Cox proportional hazard analysis was 1.62 (95% CI, 1.22 to 2.16; P&amp;lt;.001)). Sudden death – No NSVT: 8.7%, NSVT: 23.7% (RR, 2.77; 95% CI, 1.78 to 4.44; P&amp;lt;.001). Progressive heart failure death – No NSVT: 17.5%, NSVT: 20.8% (P=.22). Couplets prediction of total all-cause mortality: RR, 1.81; 95% CI, 1.22 to 2.66; P&amp;lt;.002 ; sudden death: RR, 3.37; 95% CI, 1.57 to 7.25; P&amp;lt;.0005. Couplets±NSVT prediction of sudden death: RR, 10.1; 95% CI, 1.91 to 52.7; P&amp;lt;.01.&lt;br /&gt;
&lt;br /&gt;
8. &#039;&#039;&#039;CHF-STAT (Congestive heart failure: Survival trial of antiarrhythmic therapy)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 674, Amiodarone: 336, Placebo: 338&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: to determine whether Amiodarone can reduce overall mortality in patients with congestive heart failure and asymptomatic ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%, ≥10 PVCs/hr&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: The rate of sudden death was 15% in the Amiodarone group and 19% in the placebo group in Ischemic Cardiomyopathy group (P=0.43). Reduction in overall mortality among the patients with nonischemic cardiomyopathy who received Amiodarone (P =0.07).&lt;br /&gt;
&lt;br /&gt;
9. &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
10. &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
11. &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
12. &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
13. &#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
14. &#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
15. &#039;&#039;&#039;MUSTT (the Multicenter Unsustained Tachycardia Trial) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Electrophysiologically guided antiarrhythmic therapy would reduce the risk of sudden death among patients with coronary artery disease, a left ventricular ejection fraction of 40 percent or less, and asymptomatic, unsustained ventricular tachycardia&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: 704 patients who underwent randomization, 351 were assigned to receive electrophysiologically guided therapy and 353 were assigned to receive no antiarrhythmic therapy.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: LVEF &amp;lt;40% + NSVT&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study:  Cardiac Arrest or Death from Arrhythmia - EP guided therapy = 25% no antiarrhythmic therapy = 32% (RR=0.73, CI=0.53-0.99). Cardiac arrest or death from arrhythmia - Treatment with Defibrillators vs w/o Defibrillator Treatment (RR=0.24; CI=0.13-0.45; P&amp;lt;0.001). &lt;br /&gt;
&lt;br /&gt;
16. &#039;&#039;&#039;MADIT II (Multicenter Automatic Defibrillator Implantation Trial - II) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To evaluate the effect of an implantable defibrillator on survival in patients with reduced left ventricular function after myocardial infarction are at risk for life threatening ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1232, ICD: 742, Conventional Medical Therapy: 490 patients&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤30% &amp;gt;10 PVCs/hr or couplets&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality – Conventional Medical Therapy: 19.8%, ICD: 14.2%(HR 0.69 (95 CI= 0.51-0.93, P=0.016).&lt;br /&gt;
&lt;br /&gt;
17. &#039;&#039;&#039;COMPANION (The Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure trial )&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Prophylactic cardiac-resynchronization therapy in the form of biventricular stimulation with a pacemaker with or without a defibrillator would reduce the risk of death and hospitalization among patients with advanced chronic heart failure and intraventricular conduction delays.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1520, Optimal Pharmacologic Therapy: 308, Cardiac- Resynchronization Therapy:  Pacemaker=617, Pacemaker– Defibrillator=595&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: Ischemic or nonischemic CM NYHA Class III-IV QRS ≥120 msec&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Pacemaker group - Primary end point mortality reduction (hazard ratio, 0.81; P=0.014), Pacemaker–defibrillator group (hazard ratio, 0.80; P=0.01). Primary end point mortality reduction: 34% - Pacemaker group (P&amp;lt;0.002), 40% - Pacemaker–Defibrillator group (P&amp;lt;0.001). Secondary end point mortality reduction: 24% - Pacemaker group (P=0.059), 36% - Pacemaker–Defibrillator group (P=0.003). &lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=File:Guha.pdf&amp;diff=619646</id>
		<title>File:Guha.pdf</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=File:Guha.pdf&amp;diff=619646"/>
		<updated>2011-12-28T17:46:46Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: uploaded a new version of &amp;amp;quot;File:Guha.pdf&amp;amp;quot;&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=614205</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=614205"/>
		<updated>2011-12-07T20:04:41Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: /* Trials of primary prevention of sudden cardiac death */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CASCADE(The Cardiac Arrest in Seatle Conventional Versus Amiodarone Drug Evaluation study) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone vs conventional therapy in patients with/without AICD&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 228 Amiodarone: 113 conventional antiarrhythmic drugs: 115(quinidine (n=33), procainamide (n = 26), combination therapy (n = 17), flecainide (n = 12). AICD: 105 (Amiodarone: 53, Conventional therapy: 52)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 13% more survival in patient population at the primary end point (total cardiac mortality, resuscitated cardiac arrest due to ventricular fibrillation, and syncopal Implanted defibrillator shocks) at the end of 6 years. (p=0.007).  With AICD 16% survival more at the primary end point( shocks preceded by complete syncope)(p=0.032) conclusively showing superiority of Amidarone over convetional therapy in secondary prevention.&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039; ESVEM (Electrophysiologic Study Versus Electrocardiographic Monitoring for Selection of Antiarrhythmic Therapy of Ventricular Tachyarrhythmias) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: EP testing and Holter monitor of 7 antiarrhythmics (imipramine, mexiletine, procainamide, quinidine, sotalol, pirmenol, propafenone)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  486 patients were randomized and 296 patients were eventually followed up.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 33% in all 296 and 34% in Sotalol group&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  No difference between Holter- and EP-guided groups. Sotalol group had lowest recurrence rate of VT (risk ratio, 0.43; 95 percent confidence interval, 0.29 to 0.62; p&amp;lt;0.001), arrhythmic death (risk ratio, 0.50; 95 percent confidence interval, 0.26 to 0.96; P = 0.04), total death (risk ratio, 0.50; 95 percent confidence interval, 0.30 to 0.80; P = 0.004).&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039; BHAT  ( β-Blocker Heart Attack Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039; : multicenter, randomized, double-blind, and placebo-controlled trial designed to test whether the regular administration of propranolol hydrochloride to men and women who had experienced at least one myocardial infarction would result in a significant reduction in total mortality during a two- to four-year period.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 3837, Propanolol: 1916, Placebo: 1921 persons, five to 21 days after the infarction.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Total mortality during the average 25-month follow-up period was 7.2% in the propranolol group and 9.8% in the placebo group. Arteriosclerotic heart disease (ASHD) mortality was 6.2% in the propranolol group and 8.5% in the placebo group. &lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CAST (The Cardiac Arrhythmia Suppression Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Suppression of ventricular ectopy after a myocardial infarction reduces the incidence of sudden death, patients in whom ventricular ectopy could be suppressed with encainide, flecainide, or moricizine were randomly assigned to receive either active drug or placebo&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1498 patients,Encainide+Placebo: 857(432 to active drug and 425 to placebo), Flecainide+Placebo: 641 (323 to active drug and 318 to placebo).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 89 patients had died: 59 of arrhythmia (43 receiving drug vs. 16 receiving placebo; P = 0.0004), 22 of nonarrhythmic cardiac causes (17 receiving drug vs. 5 receiving placebo; P = 0.01), and 8 of noncardiac causes (3 receiving drug vs. 5 receiving placebo). Almost all cardiac deaths not due to arrhythmia were attributed to acute myocardial infarction with shock (11 patients receiving drug and 3 receiving placebo) or to chronic congestive heart failure (4 receiving drug and 2 receiving placebo). There were no differences between the patients receiving active drug and those receiving placebo in the incidence of nonlethal disqualifying ventricular tachycardia, proarrhythmia, syncope, need for a permanent pacemaker, congestive heart failure, recurrent myocardial infarction, angina, or need for coronary-artery bypass grafting or angioplasty.&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039; SWORD (The Survival With Oral d-Sotalol (SWORD) trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;:  whether d-sotalol, could reduce all-cause mortality in patients with Left ventricular dysfunction after myocardial infarction .&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 3121, d-Sotalol : 1549, placebo : 1572 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  Mortality : d-sotalol: 78 deaths (5.0%), Placebo: 48 deaths (3.1%) (relative risk 1.65 [95% CI 115–2.36], p=0.006). Presumed arrhythmic deaths (relative risk 1.77 [1.15–2.74], p=0.008). The effect was greater in patients with a left ventricular ejection fraction of 31–40% than in those with lower (≤30%) ejection fractions (relative risk 4.0 vs 1.2, p=0.007).&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;EMIAT (The European Myocardial Infarct Amiodarone Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone effect on reduction of mortality in patients of myocardial infarction with impaired ventricular function, irrespective of whether they had ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1486, Amiodarone : 743, Placebo : 743&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone group, there was a 35% risk reduction (95% CI 0–58, p=0.05) in arrhythmic deaths.&lt;br /&gt;
&lt;br /&gt;
6. &#039;&#039;&#039;CAMIAT (The Cardiac Arrhythmia Suppression Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess the effect of amiodarone on the risk of resuscitated ventricular fibrillation or arrhythmic death among survivors of myocardial infarction with frequent or repetitive VPDs (≥10 VPDs per h or ≥1 run of ventricular tachycardia).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 1202, Amiodarone :  606, Placebo: 596&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;:&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Analysis: resuscitated ventricular fibrillation or arrhythmic death – Placebo : 31 (6.0%) Amiodarone : 15 (3.3%) (relative-risk reduction 48.5% [95% CI 4.5 to 72.2], p=0.016). Intention-to-treat analysis: primary outcome events Placebo : 24 (6.9%) Amiodarone : 15 (4.5 (38.2% [95% CI –2.1 to 62.6], p=0.029). The absolute-risk reductions were greatest among patients with congestive heart failure or a history of myocardial infarction.&lt;br /&gt;
&lt;br /&gt;
7. &#039;&#039;&#039;GESICA (the Gruppo de Estudo de la Sobrevida en la Insuficiencia Cardiaca en Argentina)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To determine the prognostic value of nonsustained ventricular tachycardia (NSVT) in total mortality in severe congestive heart failure (CHF) and predictive value of NSVT as a marker for sudden death or death due to progressive heart failure. &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 516, NSVT: 173 (33.5%), No NSVT: and 343 (66.5&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Study: Mortality - NSVT: 87(50.3%) No NSVT: (30.9%) (RR = 1.69 (95% confidence interval [CI], 1.27 to 2.24; P&amp;lt;.0002; Cox proportional hazard analysis was 1.62 (95% CI, 1.22 to 2.16; P&amp;lt;.001)). Sudden death – No NSVT: 8.7%, NSVT: 23.7% (RR, 2.77; 95% CI, 1.78 to 4.44; P&amp;lt;.001). Progressive heart failure death – No NSVT: 17.5%, NSVT: 20.8% (P=.22). Couplets prediction of total all-cause mortality: RR, 1.81; 95% CI, 1.22 to 2.66; P&amp;lt;.002 ; sudden death: RR, 3.37; 95% CI, 1.57 to 7.25; P&amp;lt;.0005. Couplets±NSVT prediction of sudden death: RR, 10.1; 95% CI, 1.91 to 52.7; P&amp;lt;.01.&lt;br /&gt;
&lt;br /&gt;
8. &#039;&#039;&#039;CHF-STAT (Congestive heart failure: Survival trial of antiarrhythmic therapy)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 674, Amiodarone: 336, Placebo: 338&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: to determine whether Amiodarone can reduce overall mortality in patients with congestive heart failure and asymptomatic ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%, ≥10 PVCs/hr&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: The rate of sudden death was 15% in the Amiodarone group and 19% in the placebo group in Ischemic Cardiomyopathy group (P=0.43). Reduction in overall mortality among the patients with nonischemic cardiomyopathy who received Amiodarone (P =0.07).&lt;br /&gt;
&lt;br /&gt;
9. &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
10. &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
11. &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
12. &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
13. &#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
14. &#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=613967</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=613967"/>
		<updated>2011-12-05T16:11:10Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: /* Trials of primary prevention of sudden cardiac death */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CASCADE(The Cardiac Arrest in Seatle Conventional Versus Amiodarone Drug Evaluation study) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone vs conventional therapy in patients with/without AICD&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 228 Amiodarone: 113 conventional antiarrhythmic drugs: 115(quinidine (n=33), procainamide (n = 26), combination therapy (n = 17), flecainide (n = 12). AICD: 105 (Amiodarone: 53, Conventional therapy: 52)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 13% more survival in patient population at the primary end point (total cardiac mortality, resuscitated cardiac arrest due to ventricular fibrillation, and syncopal Implanted defibrillator shocks) at the end of 6 years. (p=0.007).  With AICD 16% survival more at the primary end point( shocks preceded by complete syncope)(p=0.032) conclusively showing superiority of Amidarone over convetional therapy in secondary prevention.&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039; ESVEM (Electrophysiologic Study Versus Electrocardiographic Monitoring for Selection of Antiarrhythmic Therapy of Ventricular Tachyarrhythmias) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: EP testing and Holter monitor of 7 antiarrhythmics (imipramine, mexiletine, procainamide, quinidine, sotalol, pirmenol, propafenone)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  486 patients were randomized and 296 patients were eventually followed up.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 33% in all 296 and 34% in Sotalol group&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  No difference between Holter- and EP-guided groups. Sotalol group had lowest recurrence rate of VT (risk ratio, 0.43; 95 percent confidence interval, 0.29 to 0.62; p&amp;lt;0.001), arrhythmic death (risk ratio, 0.50; 95 percent confidence interval, 0.26 to 0.96; P = 0.04), total death (risk ratio, 0.50; 95 percent confidence interval, 0.30 to 0.80; P = 0.004).&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039; BHAT  ( β-Blocker Heart Attack Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039; : multicenter, randomized, double-blind, and placebo-controlled trial designed to test whether the regular administration of propranolol hydrochloride to men and women who had experienced at least one myocardial infarction would result in a significant reduction in total mortality during a two- to four-year period.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 3837, Propanolol: 1916, Placebo: 1921 persons, five to 21 days after the infarction.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Total mortality during the average 25-month follow-up period was 7.2% in the propranolol group and 9.8% in the placebo group. Arteriosclerotic heart disease (ASHD) mortality was 6.2% in the propranolol group and 8.5% in the placebo group. &lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CAST (The Cardiac Arrhythmia Suppression Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Suppression of ventricular ectopy after a myocardial infarction reduces the incidence of sudden death, patients in whom ventricular ectopy could be suppressed with encainide, flecainide, or moricizine were randomly assigned to receive either active drug or placebo&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1498 patients,Encainide+Placebo: 857(432 to active drug and 425 to placebo), Flecainide+Placebo: 641 (323 to active drug and 318 to placebo).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 89 patients had died: 59 of arrhythmia (43 receiving drug vs. 16 receiving placebo; P = 0.0004), 22 of nonarrhythmic cardiac causes (17 receiving drug vs. 5 receiving placebo; P = 0.01), and 8 of noncardiac causes (3 receiving drug vs. 5 receiving placebo). Almost all cardiac deaths not due to arrhythmia were attributed to acute myocardial infarction with shock (11 patients receiving drug and 3 receiving placebo) or to chronic congestive heart failure (4 receiving drug and 2 receiving placebo). There were no differences between the patients receiving active drug and those receiving placebo in the incidence of nonlethal disqualifying ventricular tachycardia, proarrhythmia, syncope, need for a permanent pacemaker, congestive heart failure, recurrent myocardial infarction, angina, or need for coronary-artery bypass grafting or angioplasty.&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039; SWORD (The Survival With Oral d-Sotalol (SWORD) trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;:  whether d-sotalol, could reduce all-cause mortality in patients with Left ventricular dysfunction after myocardial infarction .&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 3121, d-Sotalol : 1549, placebo : 1572 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  Mortality : d-sotalol: 78 deaths (5.0%), Placebo: 48 deaths (3.1%) (relative risk 1.65 [95% CI 115–2.36], p=0.006). Presumed arrhythmic deaths (relative risk 1.77 [1.15–2.74], p=0.008). The effect was greater in patients with a left ventricular ejection fraction of 31–40% than in those with lower (≤30%) ejection fractions (relative risk 4.0 vs 1.2, p=0.007).&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;EMIAT (The European Myocardial Infarct Amiodarone Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone effect on reduction of mortality in patients of myocardial infarction with impaired ventricular function, irrespective of whether they had ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1486, Amiodarone : 743, Placebo : 743&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone group, there was a 35% risk reduction (95% CI 0–58, p=0.05) in arrhythmic deaths.&lt;br /&gt;
&lt;br /&gt;
6. &#039;&#039;&#039;CAMIAT (The Cardiac Arrhythmia Suppression Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess the effect of amiodarone on the risk of resuscitated ventricular fibrillation or arrhythmic death among survivors of myocardial infarction with frequent or repetitive VPDs (≥10 VPDs per h or ≥1 run of ventricular tachycardia).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 1202, Amiodarone :  606, Placebo: 596&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;:&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Analysis: resuscitated ventricular fibrillation or arrhythmic death – Placebo : 31 (6.0%) Amiodarone : 15 (3.3%) (relative-risk reduction 48.5% [95% CI 4.5 to 72.2], p=0.016). Intention-to-treat analysis: primary outcome events Placebo : 24 (6.9%) Amiodarone : 15 (4.5 (38.2% [95% CI –2.1 to 62.6], p=0.029). The absolute-risk reductions were greatest among patients with congestive heart failure or a history of myocardial infarction.&lt;br /&gt;
&lt;br /&gt;
7. &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
8. &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
9. &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
10. &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
11. &#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
12. &#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=613964</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=613964"/>
		<updated>2011-12-05T16:08:54Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CASCADE(The Cardiac Arrest in Seatle Conventional Versus Amiodarone Drug Evaluation study) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone vs conventional therapy in patients with/without AICD&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 228 Amiodarone: 113 conventional antiarrhythmic drugs: 115(quinidine (n=33), procainamide (n = 26), combination therapy (n = 17), flecainide (n = 12). AICD: 105 (Amiodarone: 53, Conventional therapy: 52)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 13% more survival in patient population at the primary end point (total cardiac mortality, resuscitated cardiac arrest due to ventricular fibrillation, and syncopal Implanted defibrillator shocks) at the end of 6 years. (p=0.007).  With AICD 16% survival more at the primary end point( shocks preceded by complete syncope)(p=0.032) conclusively showing superiority of Amidarone over convetional therapy in secondary prevention.&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039; ESVEM (Electrophysiologic Study Versus Electrocardiographic Monitoring for Selection of Antiarrhythmic Therapy of Ventricular Tachyarrhythmias) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: EP testing and Holter monitor of 7 antiarrhythmics (imipramine, mexiletine, procainamide, quinidine, sotalol, pirmenol, propafenone)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  486 patients were randomized and 296 patients were eventually followed up.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 33% in all 296 and 34% in Sotalol group&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  No difference between Holter- and EP-guided groups. Sotalol group had lowest recurrence rate of VT (risk ratio, 0.43; 95 percent confidence interval, 0.29 to 0.62; p&amp;lt;0.001), arrhythmic death (risk ratio, 0.50; 95 percent confidence interval, 0.26 to 0.96; P = 0.04), total death (risk ratio, 0.50; 95 percent confidence interval, 0.30 to 0.80; P = 0.004).&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039; BHAT  ( β-Blocker Heart Attack Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039; : multicenter, randomized, double-blind, and placebo-controlled trial designed to test whether the regular administration of propranolol hydrochloride to men and women who had experienced at least one myocardial infarction would result in a significant reduction in total mortality during a two- to four-year period.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 3837, Propanolol: 1916, Placebo: 1921 persons, five to 21 days after the infarction.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Total mortality during the average 25-month follow-up period was 7.2% in the propranolol group and 9.8% in the placebo group. Arteriosclerotic heart disease (ASHD) mortality was 6.2% in the propranolol group and 8.5% in the placebo group. &lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CAST (The Cardiac Arrhythmia Suppression Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Suppression of ventricular ectopy after a myocardial infarction reduces the incidence of sudden death, patients in whom ventricular ectopy could be suppressed with encainide, flecainide, or moricizine were randomly assigned to receive either active drug or placebo&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1498 patients,Encainide+Placebo: 857(432 to active drug and 425 to placebo), Flecainide+Placebo: 641 (323 to active drug and 318 to placebo).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 89 patients had died: 59 of arrhythmia (43 receiving drug vs. 16 receiving placebo; P = 0.0004), 22 of nonarrhythmic cardiac causes (17 receiving drug vs. 5 receiving placebo; P = 0.01), and 8 of noncardiac causes (3 receiving drug vs. 5 receiving placebo). Almost all cardiac deaths not due to arrhythmia were attributed to acute myocardial infarction with shock (11 patients receiving drug and 3 receiving placebo) or to chronic congestive heart failure (4 receiving drug and 2 receiving placebo). There were no differences between the patients receiving active drug and those receiving placebo in the incidence of nonlethal disqualifying ventricular tachycardia, proarrhythmia, syncope, need for a permanent pacemaker, congestive heart failure, recurrent myocardial infarction, angina, or need for coronary-artery bypass grafting or angioplasty.&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039; SWORD (The Survival With Oral d-Sotalol (SWORD) trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;:  whether d-sotalol, could reduce all-cause mortality in patients with Left ventricular dysfunction after myocardial infarction .&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 3121, d-Sotalol : 1549, placebo : 1572 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  Mortality : d-sotalol: 78 deaths (5•0%), Placebo: 48 deaths (3•1%) (relative risk 1•65 [95% CI 1•15–2•36], p=0•006). Presumed arrhythmic deaths (relative risk 1•77 [1•15–2•74], p=0•008). The effect was greater in patients with a left ventricular ejection fraction of 31–40% than in those with lower (≤30%) ejection fractions (relative risk 4•0 vs 1•2, p=0•007).&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;EMIAT (The European Myocardial Infarct Amiodarone Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone effect on reduction of mortality in patients of myocardial infarction with impaired ventricular function, irrespective of whether they had ventricular arrhythmias.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1486, Amiodarone : 743, Placebo : 743&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone group, there was a 35% risk reduction (95% CI 0–58, p=0•05) in arrhythmic deaths.&lt;br /&gt;
&lt;br /&gt;
6. &#039;&#039;&#039;CAMIAT (The Cardiac Arrhythmia Suppression Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess the effect of amiodarone on the risk of resuscitated ventricular fibrillation or arrhythmic death among survivors of myocardial infarction with frequent or repetitive VPDs (≥10 VPDs per h or ≥1 run of ventricular tachycardia).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total : 1202, Amiodarone :  606, Placebo: 596&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;:&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Efficacy Analysis: resuscitated ventricular fibrillation or arrhythmic death – Placebo : 31 (6•0%) Amiodarone : 15 (3•3%) (relative-risk reduction 48•5% [95% CI 4•5 to 72•2], p=0•016). Intention-to-treat analysis: primary outcome events Placebo : 24 (6•9%) Amiodarone : 15 (4•5 (38•2% [95% CI –2•1 to 62•6], p=0•029). The absolute-risk reductions were greatest among patients with congestive heart failure or a history of myocardial infarction.&lt;br /&gt;
&lt;br /&gt;
7. &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
8. &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
9. &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
10. &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
11. &#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
12. &#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=613948</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=613948"/>
		<updated>2011-12-05T14:40:18Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CASCADE(The Cardiac Arrest in Seatle Conventional Versus Amiodarone Drug Evaluation study) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone vs conventional therapy in patients with/without AICD&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 228 Amiodarone: 113 conventional antiarrhythmic drugs: 115(quinidine (n=33), procainamide (n = 26), combination therapy (n = 17), flecainide (n = 12). AICD: 105 (Amiodarone: 53, Conventional therapy: 52)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 13% more survival in patient population at the primary end point (total cardiac mortality, resuscitated cardiac arrest due to ventricular fibrillation, and syncopal Implanted defibrillator shocks) at the end of 6 years. (p=0.007).  With AICD 16% survival more at the primary end point( shocks preceded by complete syncope)(p=0.032) conclusively showing superiority of Amidarone over convetional therapy in secondary prevention.&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039; ESVEM (Electrophysiologic Study Versus Electrocardiographic Monitoring for Selection of Antiarrhythmic Therapy of Ventricular Tachyarrhythmias) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: EP testing and Holter monitor of 7 antiarrhythmics (imipramine, mexiletine, procainamide, quinidine, sotalol, pirmenol, propafenone)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  486 patients were randomized and 296 patients were eventually followed up.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 33% in all 296 and 34% in Sotalol group&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  No difference between Holter- and EP-guided groups. Sotalol group had lowest recurrence rate of VT (risk ratio, 0.43; 95 percent confidence interval, 0.29 to 0.62; p&amp;lt;0.001), arrhythmic death (risk ratio, 0.50; 95 percent confidence interval, 0.26 to 0.96; P = 0.04), total death (risk ratio, 0.50; 95 percent confidence interval, 0.30 to 0.80; P = 0.004).&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039; BHAT  ( β-Blocker Heart Attack Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039; : multicenter, randomized, double-blind, and placebo-controlled trial designed to test whether the regular administration of propranolol hydrochloride to men and women who had experienced at least one myocardial infarction would result in a significant reduction in total mortality during a two- to four-year period.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 3837, Propanolol: 1916, Placebo: 1921 persons, five to 21 days after the infarction.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Total mortality during the average 25-month follow-up period was 7.2% in the propranolol group and 9.8% in the placebo group. Arteriosclerotic heart disease (ASHD) mortality was 6.2% in the propranolol group and 8.5% in the placebo group. &lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CAST (The Cardiac Arrhythmia Suppression Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Suppression of ventricular ectopy after a myocardial infarction reduces the incidence of sudden death, patients in whom ventricular ectopy could be suppressed with encainide, flecainide, or moricizine were randomly assigned to receive either active drug or placebo&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1498 patients,Encainide+Placebo: 857(432 to active drug and 425 to placebo), Flecainide+Placebo: 641 (323 to active drug and 318 to placebo).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 89 patients had died: 59 of arrhythmia (43 receiving drug vs. 16 receiving placebo; P = 0.0004), 22 of nonarrhythmic cardiac causes (17 receiving drug vs. 5 receiving placebo; P = 0.01), and 8 of noncardiac causes (3 receiving drug vs. 5 receiving placebo). Almost all cardiac deaths not due to arrhythmia were attributed to acute myocardial infarction with shock (11 patients receiving drug and 3 receiving placebo) or to chronic congestive heart failure (4 receiving drug and 2 receiving placebo). There were no differences between the patients receiving active drug and those receiving placebo in the incidence of nonlethal disqualifying ventricular tachycardia, proarrhythmia, syncope, need for a permanent pacemaker, congestive heart failure, recurrent myocardial infarction, angina, or need for coronary-artery bypass grafting or angioplasty.&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
6. &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
7. &#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
8. &#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=613940</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=613940"/>
		<updated>2011-12-05T01:43:29Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CASCADE(The Cardiac Arrest in Seatle Conventional Versus Amiodarone Drug Evaluation study) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone vs conventional therapy in patients with/without AICD&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 228 Amiodarone: 113 conventional antiarrhythmic drugs: 115(quinidine (n=33), procainamide (n = 26), combination therapy (n = 17), flecainide (n = 12). AICD: 105 (Amiodarone: 53, Conventional therapy: 52)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 13% more survival in patient population at the primary end point (total cardiac mortality, resuscitated cardiac arrest due to ventricular fibrillation, and syncopal Implanted defibrillator shocks) at the end of 6 years. (p=0.007).  With AICD 16% survival more at the primary end point( shocks preceded by complete syncope)(p=0.032) conclusively showing superiority of Amidarone over convetional therapy in secondary prevention.&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039; ESVEM (Electrophysiologic Study Versus Electrocardiographic Monitoring for Selection of Antiarrhythmic Therapy of Ventricular Tachyarrhythmias) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: EP testing and Holter monitor of 7 antiarrhythmics (imipramine, mexiletine, procainamide, quinidine, sotalol, pirmenol, propafenone)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  486 patients were randomized and 296 patients were eventually followed up.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 33% in all 296 and 34% in Sotalol group&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  No difference between Holter- and EP-guided groups. Sotalol group had lowest recurrence rate of VT (risk ratio, 0.43; 95 percent confidence interval, 0.29 to 0.62; p&amp;lt;0.001), arrhythmic death (risk ratio, 0.50; 95 percent confidence interval, 0.26 to 0.96; P = 0.04), total death (risk ratio, 0.50; 95 percent confidence interval, 0.30 to 0.80; P = 0.004).&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death with implantable cardiac defibrillators.===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039; BHAT  ( β-Blocker Heart Attack Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039; : multicenter, randomized, double-blind, and placebo-controlled trial designed to test whether the regular administration of propranolol hydrochloride to men and women who had experienced at least one myocardial infarction would result in a significant reduction in total mortality during a two- to four-year period.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 3837, Propanolol: 1916, Placebo: 1921 persons, five to 21 days after the infarction.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Total mortality during the average 25-month follow-up period was 7.2% in the propranolol group and 9.8% in the placebo group. Arteriosclerotic heart disease (ASHD) mortality was 6.2% in the propranolol group and 8.5% in the placebo group. &lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CAST (The Cardiac Arrhythmia Suppression Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Suppression of ventricular ectopy after a myocardial infarction reduces the incidence of sudden death, patients in whom ventricular ectopy could be suppressed with encainide, flecainide, or moricizine were randomly assigned to receive either active drug or placebo&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1498 patients,Encainide+Placebo: 857(432 to active drug and 425 to placebo), Flecainide+Placebo: 641 (323 to active drug and 318 to placebo).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 89 patients had died: 59 of arrhythmia (43 receiving drug vs. 16 receiving placebo; P = 0.0004), 22 of nonarrhythmic cardiac causes (17 receiving drug vs. 5 receiving placebo; P = 0.01), and 8 of noncardiac causes (3 receiving drug vs. 5 receiving placebo). Almost all cardiac deaths not due to arrhythmia were attributed to acute myocardial infarction with shock (11 patients receiving drug and 3 receiving placebo) or to chronic congestive heart failure (4 receiving drug and 2 receiving placebo). There were no differences between the patients receiving active drug and those receiving placebo in the incidence of nonlethal disqualifying ventricular tachycardia, proarrhythmia, syncope, need for a permanent pacemaker, congestive heart failure, recurrent myocardial infarction, angina, or need for coronary-artery bypass grafting or angioplasty.&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
6. &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
7. &#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
8. &#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=613939</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=613939"/>
		<updated>2011-12-05T01:31:36Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CASCADE(The Cardiac Arrest in Seatle Conventional Versus Amiodarone Drug Evaluation study) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone vs conventional therapy in patients with/without AICD&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 228 Amiodarone: 113 conventional antiarrhythmic drugs: 115(quinidine (n=33), procainamide (n = 26), combination therapy (n = 17), flecainide (n = 12). AICD: 105 (Amiodarone: 53, Conventional therapy: 52)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 13% more survival in patient population at the primary end point (total cardiac mortality, resuscitated cardiac arrest due to ventricular fibrillation, and syncopal Implanted defibrillator shocks) at the end of 6 years. (p=0.007).  With AICD 16% survival more at the primary end point( shocks preceded by complete syncope)(p=0.032) conclusively showing superiority of Amidarone over convetional therapy in secondary prevention.&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039; ESVEM (Electrophysiologic Study Versus Electrocardiographic Monitoring for Selection of Antiarrhythmic Therapy of Ventricular Tachyarrhythmias) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: EP testing and Holter monitor of 7 antiarrhythmics (imipramine, mexiletine, procainamide, quinidine, sotalol, pirmenol, propafenone)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  486 patients were randomized and 296 patients were eventually followed up.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 33% in all 296 and 34% in Sotalol group&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  No difference between Holter- and EP-guided groups. Sotalol group had lowest recurrence rate of VT (risk ratio, 0.43; 95 percent confidence interval, 0.29 to 0.62; p&amp;lt;0.001), arrhythmic death (risk ratio, 0.50; 95 percent confidence interval, 0.26 to 0.96; P = 0.04), total death (risk ratio, 0.50; 95 percent confidence interval, 0.30 to 0.80; P = 0.004).&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death with implantable cardiac defibrillators.===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039; BHAT  ( β-Blocker Heart Attack Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039; : multicenter, randomized, double-blind, and placebo-controlled trial designed to test whether the regular administration of propranolol hydrochloride to men and women who had experienced at least one myocardial infarction would result in a significant reduction in total mortality during a two- to four-year period.&lt;br /&gt;
&lt;br /&gt;
 * &#039;&#039;&#039;Demographics&#039;&#039;&#039;: 3,837 persons between the ages of 30 and 69 years were randomized to either propranolol (1,916 persons) or placebo (1,921 persons), five to 21 days after the infarction.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Total mortality during the average 25-month follow-up period was 7.2% in the propranolol group and 9.8% in the placebo group. Arteriosclerotic heart disease (ASHD) mortality was 6.2% in the propranolol group and 8.5% in the placebo group. &lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CAST (The Cardiac Arrhythmia Suppression Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Suppression of ventricular ectopy after a myocardial infarction reduces the incidence of sudden death, patients in whom ventricular ectopy could be suppressed with encainide, flecainide, or moricizine were randomly assigned to receive either active drug or placebo&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: 1498 patients, 857 were assigned to receive encainide or its placebo (432 to active drug and 425 to placebo) and 641 were assigned to receive flecainide or its placebo (323 to active drug and 318 to placebo).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 89 patients had died: 59 of arrhythmia (43 receiving drug vs. 16 receiving placebo; P = 0.0004), 22 of nonarrhythmic cardiac causes (17 receiving drug vs. 5 receiving placebo; P = 0.01), and 8 of noncardiac causes (3 receiving drug vs. 5 receiving placebo). Almost all cardiac deaths not due to arrhythmia were attributed to acute myocardial infarction with shock (11 patients receiving drug and 3 receiving placebo) or to chronic congestive heart failure (4 receiving drug and 2 receiving placebo). There were no differences between the patients receiving active drug and those receiving placebo in the incidence of nonlethal disqualifying ventricular tachycardia, proarrhythmia, syncope, need for a permanent pacemaker, congestive heart failure, recurrent myocardial infarction, angina, or need for coronary-artery bypass grafting or angioplasty.&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
6. &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
7. &#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
8. &#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=613938</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=613938"/>
		<updated>2011-12-05T01:30:52Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CASCADE(The Cardiac Arrest in Seatle Conventional Versus Amiodarone Drug Evaluation study) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone vs conventional therapy in patients with/without AICD&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 228 Amiodarone: 113 conventional antiarrhythmic drugs: 115(quinidine (n=33), procainamide (n = 26), combination therapy (n = 17), flecainide (n = 12). AICD: 105 (Amiodarone: 53, Conventional therapy: 52)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 13% more survival in patient population at the primary end point (total cardiac mortality, resuscitated cardiac arrest due to ventricular fibrillation, and syncopal Implanted defibrillator shocks) at the end of 6 years. (p=0.007).  With AICD 16% survival more at the primary end point( shocks preceded by complete syncope)(p=0.032) conclusively showing superiority of Amidarone over convetional therapy in secondary prevention.&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039; ESVEM (Electrophysiologic Study Versus Electrocardiographic Monitoring for Selection of Antiarrhythmic Therapy of Ventricular Tachyarrhythmias) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: EP testing and Holter monitor of 7 antiarrhythmics (imipramine, mexiletine, procainamide, quinidine, sotalol, pirmenol, propafenone)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  486 patients were randomized and 296 patients were eventually followed up.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 33% in all 296 and 34% in Sotalol group&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  No difference between Holter- and EP-guided groups. Sotalol group had lowest recurrence rate of VT (risk ratio, 0.43; 95 percent confidence interval, 0.29 to 0.62; p&amp;lt;0.001), arrhythmic death (risk ratio, 0.50; 95 percent confidence interval, 0.26 to 0.96; P = 0.04), total death (risk ratio, 0.50; 95 percent confidence interval, 0.30 to 0.80; P = 0.004).&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death with implantable cardiac defibrillators.===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039; BHAT  ( β-Blocker Heart Attack Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039; : multicenter, randomized, double-blind, and placebo-controlled trial designed to test whether the regular administration of propranolol hydrochloride to men and women who had experienced at least one myocardial infarction would result in a significant reduction in total mortality during a two- to four-year period.&lt;br /&gt;
&lt;br /&gt;
 * &#039;&#039;&#039;Demographics&#039;&#039;&#039;: 3,837 persons between the ages of 30 and 69 years were randomized to either propranolol (1,916 persons) or placebo (1,921 persons), five to 21 days after the infarction.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Total mortality during the average 25-month follow-up period was 7.2% in the propranolol group and 9.8% in the placebo group. Arteriosclerotic heart disease (ASHD) mortality was 6.2% in the propranolol group and 8.5% in the placebo group. &lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039; CAST (The Cardiac Arrhythmia Suppression Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Suppression of ventricular ectopy after a myocardial infarction reduces the incidence of sudden death, patients in whom ventricular ectopy could be suppressed with encainide, flecainide, or moricizine were randomly assigned to receive either active drug or placebo&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: 1498 patients, 857 were assigned to receive encainide or its placebo (432 to active drug and 425 to placebo) and 641 were assigned to receive flecainide or its placebo (323 to active drug and 318 to placebo).&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: ≤40%&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 89 patients had died: 59 of arrhythmia (43 receiving drug vs. 16 receiving placebo; P = 0.0004), 22 of nonarrhythmic cardiac causes (17 receiving drug vs. 5 receiving placebo; P = 0.01), and 8 of noncardiac causes (3 receiving drug vs. 5 receiving placebo). Almost all cardiac deaths not due to arrhythmia were attributed to acute myocardial infarction with shock (11 patients receiving drug and 3 receiving placebo) or to chronic congestive heart failure (4 receiving drug and 2 receiving placebo). There were no differences between the patients receiving active drug and those receiving placebo in the incidence of nonlethal disqualifying ventricular tachycardia, proarrhythmia, syncope, need for a permanent pacemaker, congestive heart failure, recurrent myocardial infarction, angina, or need for coronary-artery bypass grafting or angioplasty.&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
6. &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
7. &#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
8. &#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=613935</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=613935"/>
		<updated>2011-12-05T00:38:43Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;CASCADE(The Cardiac Arrest in Seatle Conventional Versus Amiodarone Drug Evaluation study) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Amiodarone vs conventional therapy in patients with/without AICD&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  Total: 228 Amiodarone: 113 conventional antiarrhythmic drugs: 115(quinidine (n=33), procainamide (n = 26), combination therapy (n = 17), flecainide (n = 12). AICD: 105 (Amiodarone: 53, Conventional therapy: 52)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 13% more survival in patient population at the primary end point (total cardiac mortality, resuscitated cardiac arrest due to ventricular fibrillation, and syncopal Implanted defibrillator shocks) at the end of 6 years. (p=0.007).  With AICD 16% survival more at the primary end point( shocks preceded by complete syncope)(p=0.032) conclusively showing superiority of Amidarone over convetional therapy in secondary prevention.&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039; ESVEM (Electrophysiologic Study Versus Electrocardiographic Monitoring for Selection of Antiarrhythmic Therapy of Ventricular Tachyarrhythmias) &#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: EP testing and Holter monitor of 7 antiarrhythmics (imipramine, mexiletine, procainamide, quinidine, sotalol, pirmenol, propafenone)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;:  486 patients were randomized and 296 patients were eventually followed up.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 33% in all 296 and 34% in Sotalol group&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;:  No difference between Holter- and EP-guided groups. Sotalol group had lowest recurrence rate of VT (risk ratio, 0.43; 95 percent confidence interval, 0.29 to 0.62; p&amp;lt;0.001), arrhythmic death (risk ratio, 0.50; 95 percent confidence interval, 0.26 to 0.96; P = 0.04), total death (risk ratio, 0.50; 95 percent confidence interval, 0.30 to 0.80; P = 0.004).&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death with implantable cardiac defibrillators.===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
6. &#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_medical_therapy&amp;diff=611332</id>
		<title>Ventricular tachycardia medical therapy</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_medical_therapy&amp;diff=611332"/>
		<updated>2011-10-31T16:35:56Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}};&#039;&#039;&#039;Associate Editor-In-Chief:&#039;&#039;&#039; {{CZ}}, [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
&lt;br /&gt;
===Antiarrhythmic drug therapy===&lt;br /&gt;
Drugs such as [[amiodarone]], [[epinephrine]] and [[vasopressin]] may be used in addition to [[defibrillation]] to terminate VT while the underlying cause of the VT can be determined. Possible causes or contributing factors to VT can be remembered as the six H&#039;s and five T&#039;s: Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hypo- or Hyperglycemia, Hypothermia; and Toxins, Tamponade (cardiac), Tension pneumothorax, Thrombosis, Trauma.  &lt;br /&gt;
&lt;br /&gt;
Long term anti-arrhythmic therapy may be indicated to prevent recurrence of VT. [[Beta-blockers]] and a number of class III anti-arrhythmics are commonly used.  &lt;br /&gt;
&lt;br /&gt;
For some of the rare congenital syndromes of VT, other drugs, and sometimes even [[clinical cardiac electrophysiology#catheter ablation|catheter ablation therapy]] may be useful.&lt;br /&gt;
&lt;br /&gt;
The implantation of an [[ICD]] is more effective than drug therapy for prevention of sudden cardiac death due to [[VT]] and [[VF]], but may be constrained by cost issues, and well as patient co-morbidities and patient preference.&lt;br /&gt;
&lt;br /&gt;
===Trials on Beta-Blockers on Mortality in Patients With Heart Disease and Complex Ventricular Arrhythmias===&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
[[Category : Electrophysiology]]&lt;br /&gt;
&lt;br /&gt;
{{WS}}&lt;br /&gt;
{{WH}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611330</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611330"/>
		<updated>2011-10-31T16:31:03Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death with implantable cardiac defibrillators.===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
3. &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
4. &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
5. &#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
6. &#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611326</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611326"/>
		<updated>2011-10-31T16:16:37Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
*:* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
*#* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
*#* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
*#* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death with implantable cardiac defibrillators.===&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611324</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611324"/>
		<updated>2011-10-31T16:16:04Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
*#*:* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
*#* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
*#* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
*#* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death with implantable cardiac defibrillators.===&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611323</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611323"/>
		<updated>2011-10-31T16:14:57Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
*# &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
*#* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
*#* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
*#* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
*#* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death with implantable cardiac defibrillators.===&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611322</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611322"/>
		<updated>2011-10-31T16:13:15Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
1. &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
** &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
** &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
** &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
** &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
2. &#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death with implantable cardiac defibrillators.===&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611321</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611321"/>
		<updated>2011-10-31T16:11:42Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death with implantable cardiac defibrillators.===&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611320</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611320"/>
		<updated>2011-10-31T16:11:17Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
#* &#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
#* &#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
#* &#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
#* &#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death with implantable cardiac defibrillators.===&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611317</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611317"/>
		<updated>2011-10-31T16:09:23Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
#*&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death with implantable cardiac defibrillators.===&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611315</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611315"/>
		<updated>2011-10-31T16:08:09Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death with implantable cardiac defibrillators.===&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;AMIOVIRT (Amiodarone versus Implantable Defibrillator)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611306</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611306"/>
		<updated>2011-10-31T16:03:27Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: /* Landmark Clinical Trials */&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
#&#039;&#039;&#039;CIDS (Canadian Implantable Defibrillator Study)&#039;&#039;&#039; &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;CASH (Cardiac Arrest Study Hamburg)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 45&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death with implantable cardiac defibrillators.===&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;MADIT I (Multicenter Automatic Defibrillator Implantation Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 35&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Result&#039;&#039;&#039;: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;&#039;CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)&#039;&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Strategy&#039;&#039;&#039;: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Demographics&#039;&#039;&#039;: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;&#039;Mean EF&#039;&#039;&#039;: 30&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
# ‘’AMIOVIRT (Amiodarone versus Implantable Defibrillator)’’&lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: Nonischemic dilated cardiomyopathy patients with nonsustained&lt;br /&gt;
VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 35&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
# ‘’DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)’’&lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 35&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
#’’DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)’’&lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 35&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
#’’SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)’’&lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611302</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611302"/>
		<updated>2011-10-31T16:00:18Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
# &#039;&#039;AVID (The Antiarrhythmics versus Implantable Defibrillators)&#039;&#039;&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;Strategy&#039;&#039;: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
##&#039;&#039;Demographics&#039;&#039;: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
#’’CIDS (Canadian Implantable Defibrillator Study)’’ &lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
# ‘’CASH (Cardiac Arrest Study Hamburg)’’&lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 45&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death with implantable cardiac defibrillators.===&lt;br /&gt;
&lt;br /&gt;
# ‘’MADIT I (Multicenter Automatic Defibrillator Implantation Trial)’’&lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 35&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
# ‘’CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)’’&lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 30&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
# ‘’AMIOVIRT (Amiodarone versus Implantable Defibrillator)’’&lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: Nonischemic dilated cardiomyopathy patients with nonsustained&lt;br /&gt;
VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 35&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
# ‘’DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)’’&lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 35&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
#’’DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)’’&lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 35&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
#’’SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)’’&lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611299</id>
		<title>Ventricular tachycardia landmark trials</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_landmark_trials&amp;diff=611299"/>
		<updated>2011-10-31T15:56:49Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: Created page with &amp;quot;{{Ventricular tachycardia}} {{CMG}}; &amp;#039;&amp;#039;&amp;#039;Associate Editor-in Chief&amp;#039;&amp;#039;&amp;#039;: Avirup Guha, M.B.B.S.[mailto:avirup.guha@gmail.com] ==Landmark Clinical Trials== ===Stud...&amp;quot;&lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
==Landmark Clinical Trials==&lt;br /&gt;
===Studies of secondary prevention of sudden cardiac death===&lt;br /&gt;
&lt;br /&gt;
# ‘’AVID (The Antiarrhythmics versus Implantable Defibrillators)’’&lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: ICD vs medication either amiodarone or sotalol&lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: Total: 1016 ICD: 507 Medications (predominantly amiodarone): 509 (80% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 32 (inclusion&amp;lt;40)&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: Relative risk reduction: 1-year: 39% ; 2-year: 27% ; 3-year: 31% (p = 0.02)&lt;br /&gt;
&lt;br /&gt;
#’’CIDS (Canadian Implantable Defibrillator Study)’’ &lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: ICD vs amiodarone&lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: Total: 659 ICD: 328 Amiodarone: 331 (82% with ischemic heart disease) &lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: &amp;lt;35&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: Relative risk reduction: 20% (p = 0.142)&lt;br /&gt;
&lt;br /&gt;
# ‘’CASH (Cardiac Arrest Study Hamburg)’’&lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: ICD vs amiodarone vs beta blocker&lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: Total: 288 (74% with ischemic heart disease) ICD: 99 Amiodarone: 92 Metoprolol: 97 &lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 45&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: Relative risk reduction at 5 years: 23% (p = 0.081)&lt;br /&gt;
&lt;br /&gt;
=== Trials of primary prevention of sudden cardiac death with implantable cardiac defibrillators.===&lt;br /&gt;
&lt;br /&gt;
# ‘’MADIT I (Multicenter Automatic Defibrillator Implantation Trial)’’&lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: Conventional medical therapy vs ICD in patients with clinical NSVT and inducible VT during EPS that is not suppressible with procainamide &lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: Medical therapy: 101 ICD arm: 95&lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 35&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: RR reduction in mortality in favor of ICD; 95% CI: 0.26-0.82; p = 0.009&lt;br /&gt;
&lt;br /&gt;
# ‘’CABG-PATCH (Coronary Artery Bypass Graft (CABG) Patch Trial)’’&lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: CAD patients undergoing CABG with abnormal signal averaged ECG randomized to ICD or control group &lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: ICD epicardial: 446 Control arm: 45 Total: 900 30days and revascularization &amp;gt; 90 days) randomized 3:2 to ICD vs conventional medical therapy ICD: 42 Conventional medical therapy: 490&lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 30&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: 31% RR reduction in favor of ICD; 95% CI: 0.51-0.93; p = 0.16&lt;br /&gt;
&lt;br /&gt;
# ‘’AMIOVIRT (Amiodarone versus Implantable Defibrillator)’’&lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: Nonischemic dilated cardiomyopathy patients with nonsustained&lt;br /&gt;
VT, randomized to ICD vs amiodarone &lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: ICD: 51 Amiodarone: 52 Total: 103&lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 35&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: No significant difference in survival&lt;br /&gt;
&lt;br /&gt;
# ‘’DEFINITE (Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation)’’&lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: Nonischemic dilated cardiomyopathy patients with nonsustained VT, randomized to ICD vs standard medical therapy&lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: Singlechamber ICD: 229 Standard medical therapy: 229 Total: 458 120 ms) in both ischemic and nonischemic causes 1520 randomized in 1:2:2 ratio to receive optimum pharmacological therapy, biventricular pacemaker alone or biventricular pacemaker defibrillator&lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 35&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: Combined end point of hospitalization and death reduced by the pacemaker alone 34% (p = 0.002) and pacemaker-ICD by 40% (p = 0.001). Secondary end point all-cause mortality reduced by defibrillator by RR-36% (p = 0.003) but not by pacemaker alone. RR: 24% (p = 0.059)&lt;br /&gt;
&lt;br /&gt;
#’’DINAMIT (Defibrillator in Acute Myocardial Infarction Trial)’’&lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: Benefit of an ICD early after an MI within 6-40 days towards reduction of mortality when compared with medical therapy&lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: ICD: 332 Control: 342 Total: 674&lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 35&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: 62 deaths in the ICD group and 58 in the control group (p = 0.66; CI: 0.76-1.55). Arrhythmic causes were less in the ICD group but nonarrhythmic causes were significantly higher and thus overall mortality was not significantly different&lt;br /&gt;
&lt;br /&gt;
#’’SCD-HeFT (Sudden Cardiac Death in Heart Failure Trial)’’&lt;br /&gt;
&lt;br /&gt;
##’’Strategy’’: To assess prognostic effect of ICD vs amiodarone vs placebo in class II and III heart failure regardless of etiology.&lt;br /&gt;
&lt;br /&gt;
##’’Demographics’’: Conventional therapy and placebo: 847 Conventional therapy and amiodarone: 845 Conventional therapy and single lead, shock only ICD: 829 Total: 2521&lt;br /&gt;
&lt;br /&gt;
##’’Mean EF’’: 35 (ischemic etiology patients 52% and nonischemic etiology 48%)&lt;br /&gt;
&lt;br /&gt;
##’’Result’’: Amiodarone and placebo outcome were comparable. ICD arm absolute risk reduction: 7.2% after 5 years; RR: 23% (p = 0.007)&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
[[Category:Cardiology]]&lt;br /&gt;
&lt;br /&gt;
{{WikiDoc Help Menu}}&lt;br /&gt;
{{WikiDoc Sources}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_electrocardiogram&amp;diff=609925</id>
		<title>Ventricular tachycardia electrocardiogram</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_electrocardiogram&amp;diff=609925"/>
		<updated>2011-10-17T14:50:31Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
&lt;br /&gt;
==Electrocardography(EKG)==&lt;br /&gt;
&lt;br /&gt;
===Overview===&lt;br /&gt;
The diagnosis of [[Ventricular tachycardia]] almost completely depends on EKG findings. The details are illustrated below. It is important to differentiate it from other wide complex tachycardias.&lt;br /&gt;
&lt;br /&gt;
===Electrocardiographic diagnostic findings&amp;lt;ref name=&#039;book1&#039;&amp;gt; Zimetbaum PJ, Josephson ME(2009). &#039;&#039;Practical Clinical Electrophysiology&#039;&#039; (1st ed.). Philadelphia, Pa: Lippincott Williams &amp;amp; Wilkins.&amp;lt;/ref&amp;gt;===&lt;br /&gt;
&lt;br /&gt;
[[Image:Lead II rhythm ventricular tachycardia Vtach VT.jpg|500 px|center|thumb|Ventricular tachycardia in Lead II (rhythm)]]&lt;br /&gt;
&lt;br /&gt;
# Abnormal and wide QRS complexes with secondary [[ST segment]] and [[T wave]] changes. &amp;lt;br&amp;gt;&lt;br /&gt;
#* Usual QRS duration is &amp;gt; 0.12 seconds, may be shorter if the ectopic focus is located in the ventricular septum.&lt;br /&gt;
#* The secondary [[ST segment]] and [[T wave]] changes are in a direction that is opposite the major deflection of the [[QRS]].&lt;br /&gt;
#* A ventricular rate between 140 and 200 BPM.&lt;br /&gt;
#* When the rate is &amp;gt;200 and has a sine wave appearance, it is called [[ventricular flutter]].&lt;br /&gt;
#* When the rate is &amp;lt;110 BPM it is called non-paroxysmal VT.&lt;br /&gt;
# A regular or slightly irregular (up to 0.03 seconds) rhythm. &amp;lt;br&amp;gt;&lt;br /&gt;
# Abrupt onset and termination. &amp;lt;br&amp;gt;&lt;br /&gt;
# AV dissociation. &amp;lt;br&amp;gt;&lt;br /&gt;
#* Atrial rate slower than ventricular rate.&lt;br /&gt;
#* No relationship between atrial activity and ventricular activity.&lt;br /&gt;
#* There can be VA conduction.&lt;br /&gt;
#*:# The RP interval is &amp;gt;0.11 seconds.&lt;br /&gt;
#*:# Occurs in about 50% of cases.&lt;br /&gt;
#*:# Uncommon when the ventricular rate is rapid (only 1/7 when the rate was&amp;gt;200).&lt;br /&gt;
# Axis &lt;br /&gt;
#* Northwest quadrant is almost always VT in adults.&lt;br /&gt;
#* In someone with a normal QRS in sinus rhythm, a LBBB-like wide complex tachycardia with a right axis (+90 to +180) is always VT because activation in LBBB aberration always goes from right to left.&lt;br /&gt;
# Concordance&lt;br /&gt;
#* If all the precordial leads are positive (R) or negative (QS) the rhythm is very likely VT&lt;br /&gt;
# V1-V2 morphology&lt;br /&gt;
#* RBBB-morphology&lt;br /&gt;
#*:# RsR&#039; or rsR&#039; in V1 favors SVT, whereas a monophasic R, Rr&#039;, qR, or RS favors VT. &lt;br /&gt;
#*:# RBBB aberration the initial forces of the QRS are the same as in the narrow complex sinus rhythm. &lt;br /&gt;
#* LBBB-morphology&lt;br /&gt;
#*:# V1 and V2 require analysis because the initial forces in V1 are often isoelectric. &lt;br /&gt;
#*:# R wave in V1 or V2 ≥40 msec favors VT. &lt;br /&gt;
#*:# The time from the onset of the QRS to the nadir of the S wave in V1 or V2 is ≥70 msec, VT is likely in the absence of Na channel blocking agents.&lt;br /&gt;
# V6 morphology&lt;br /&gt;
#* RBBB-morphology - QS or rS favors VT. Although this can be influenced by axis (it is almost always seen in VT with left axis deviation, but is seen in only approximately 50% of VT with a normal axis, even in the same patient).&lt;br /&gt;
#* LBBB-morphology - a qR or QS is highly predictive of VT&lt;br /&gt;
# Capture beats. &amp;lt;br&amp;gt;&lt;br /&gt;
#* Occurs when a supraventricular impulse is conducted and captures the ventricle.&lt;br /&gt;
#* They are rare.&lt;br /&gt;
# Fusion beats. &amp;lt;br&amp;gt;&lt;br /&gt;
#* Rare in VT at a rapid rate.&amp;lt;ref&amp;gt;Chou&#039;s Electrocardiography in Clinical Practice Third Edition, pp. 398-409.&amp;lt;/ref&amp;gt; &amp;lt;ref&amp;gt;Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:194 ISBN 1591032016&amp;lt;/ref&amp;gt; &amp;lt;ref&amp;gt;Hammill S. C. Electrocardiographic diagnoses: Criteria and definitions of abnormalities, Chapter 18, MAYO Clinic, Concise Textbook of Cardiology, 3rd edition, 2007 ISBN 0-8493-9057-5&amp;lt;/ref&amp;gt;&lt;br /&gt;
&lt;br /&gt;
====Examples of Ventricular Tachycardia:====&lt;br /&gt;
&lt;br /&gt;
&amp;lt;div align=&amp;quot;left&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;gallery heights=&amp;quot;400&amp;quot; widths=&amp;quot;400&amp;quot;&amp;gt;&lt;br /&gt;
Image:Ganseman.VT1.jpg|12 lead EKG: Ventricular tachycardia. &lt;br /&gt;
Image:Ganseman.VT2.jpg|12 lead EKG: Ventricular tachycardia. &amp;lt;small&amp;gt; [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]&amp;lt;/small&amp;gt;&lt;br /&gt;
&amp;lt;/gallery&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&amp;lt;div align=&amp;quot;left&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;gallery heights=&amp;quot;400&amp;quot; widths=&amp;quot;400&amp;quot;&amp;gt;&lt;br /&gt;
Image:Ganseman.VT3.jpg|12 lead EKG: Ventricular tachycardia. &amp;lt;small&amp;gt; [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]&amp;lt;/small&amp;gt;&lt;br /&gt;
Image:Ganseman.VT4.jpg|12 lead EKG: Ventricular tachycardia. &amp;lt;small&amp;gt; [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]&amp;lt;/small&amp;gt;&lt;br /&gt;
&amp;lt;/gallery&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&amp;lt;div align=&amp;quot;left&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;gallery heights=&amp;quot;400&amp;quot; widths=&amp;quot;400&amp;quot;&amp;gt;&lt;br /&gt;
Image:Ganseman.VT5.jpg|12 lead EKG: Ventricular tachycardia. &amp;lt;small&amp;gt; [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]&amp;lt;/small&amp;gt;&lt;br /&gt;
Image:Ganseman.VT6.jpg|12 lead EKG: Ventricular tachycardia. &amp;lt;small&amp;gt; [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]&amp;lt;/small&amp;gt;&lt;br /&gt;
&amp;lt;/gallery&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&amp;lt;div align=&amp;quot;left&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;gallery heights=&amp;quot;400&amp;quot; widths=&amp;quot;400&amp;quot;&amp;gt;&lt;br /&gt;
Image:12lead_vt1.jpg|Ventricular tachycardia of 140 bpm with a [[LBBB|left bundle branch block]] pattern and left heart axis.&lt;br /&gt;
Image:12lead_vt2.png|Ventricular tachycardia of 250 bpm with a [[RBBB|right bundle branch block]] pattern and right heart axis.&lt;br /&gt;
&amp;lt;/gallery&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&amp;lt;div align=&amp;quot;left&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;gallery heights=&amp;quot;400&amp;quot; widths=&amp;quot;400&amp;quot;&amp;gt;&lt;br /&gt;
Image:12lead_vt3.png|Ventricular tachycardia of 150 bpm with a [[RBBB|right bundle branch block]] pattern and right heart axis. Note the 5th and 6th complex from the right side. These are fusion complexes.&lt;br /&gt;
Image:ventricular_flutter_12lead.jpg|Ventricular flutter on a 12 lead ECG&lt;br /&gt;
&amp;lt;/gallery&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|1}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
{{WH}}&lt;br /&gt;
{{WS}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
	<entry>
		<id>https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_electrocardiogram&amp;diff=609924</id>
		<title>Ventricular tachycardia electrocardiogram</title>
		<link rel="alternate" type="text/html" href="https://www.wikidoc.org/index.php?title=Ventricular_tachycardia_electrocardiogram&amp;diff=609924"/>
		<updated>2011-10-17T14:43:16Z</updated>

		<summary type="html">&lt;p&gt;Avirupguha: &lt;/p&gt;
&lt;hr /&gt;
&lt;div&gt;{{Ventricular tachycardia}}&lt;br /&gt;
{{CMG}}; &#039;&#039;&#039;Associate Editor-in Chief&#039;&#039;&#039;: [[User:Avirupguha|Avirup Guha, M.B.B.S.]][mailto:avirup.guha@gmail.com]&lt;br /&gt;
&lt;br /&gt;
==Electrocardography(EKG)==&lt;br /&gt;
===Overview===&lt;br /&gt;
The diagnosis of [[Ventricular tachycardia]] almost completely depends on EKG findings. The details are illustrated below. It is important to differentiate it from other wide complex tachycardias.&lt;br /&gt;
&lt;br /&gt;
===Electrocardiographic diagnostic findings===&lt;br /&gt;
&lt;br /&gt;
[[Image:Lead II rhythm ventricular tachycardia Vtach VT.jpg|500 px|center|thumb|Ventricular tachycardia in Lead II (rhythm)]]&lt;br /&gt;
&lt;br /&gt;
# Abnormal and wide QRS complexes with secondary [[ST segment]] and [[T wave]] changes. &amp;lt;br&amp;gt;&lt;br /&gt;
#* Usual QRS duration is &amp;gt; 0.12 seconds, may be shorter if the ectopic focus is located in the ventricular septum.&lt;br /&gt;
#* The secondary [[ST segment]] and [[T wave]] changes are in a direction that is opposite the major deflection of the [[QRS]].&lt;br /&gt;
#* A ventricular rate between 140 and 200 BPM.&lt;br /&gt;
#* When the rate is &amp;gt;200 and has a sine wave appearance, it is called [[ventricular flutter]].&lt;br /&gt;
#* When the rate is &amp;lt;110 BPM it is called non-paroxysmal VT.&lt;br /&gt;
# A regular or slightly irregular (up to 0.03 seconds) rhythm. &amp;lt;br&amp;gt;&lt;br /&gt;
# Abrupt onset and termination. &amp;lt;br&amp;gt;&lt;br /&gt;
# AV dissociation. &amp;lt;br&amp;gt;&lt;br /&gt;
#* Atrial rate slower than ventricular rate.&lt;br /&gt;
#* No relationship between atrial activity and ventricular activity.&lt;br /&gt;
#* There can be VA conduction.&lt;br /&gt;
#*:# The RP interval is &amp;gt;0.11 seconds.&lt;br /&gt;
#*:# Occurs in about 50% of cases.&lt;br /&gt;
#*:# Uncommon when the ventricular rate is rapid (only 1/7 when the rate was&amp;gt;200).&lt;br /&gt;
# Axis &lt;br /&gt;
#* Northwest quadrant is almost always VT in adults.&lt;br /&gt;
#* In someone with a normal QRS in sinus rhythm, a LBBB-like wide complex tachycardia with a right axis (+90 to +180) is always VT because activation in LBBB aberration always goes from right to left.&lt;br /&gt;
# Concordance&lt;br /&gt;
#* If all the precordial leads are positive (R) or negative (QS) the rhythm is very likely VT&lt;br /&gt;
# V1-V2 morphology&lt;br /&gt;
#* RBBB-morphology&lt;br /&gt;
#*:# RsR&#039; or rsR&#039; in V1 favors SVT, whereas a monophasic R, Rr&#039;, qR, or RS favors VT. &lt;br /&gt;
#*:# RBBB aberration the initial forces of the QRS are the same as in the narrow complex sinus rhythm. &lt;br /&gt;
#* LBBB-morphology&lt;br /&gt;
#*:# V1 and V2 require analysis because the initial forces in V1 are often isoelectric. &lt;br /&gt;
#*:# R wave in V1 or V2 ≥40 msec favors VT. &lt;br /&gt;
#*:# The time from the onset of the QRS to the nadir of the S wave in V1 or V2 is ≥70 msec, VT is likely in the absence of Na channel blocking agents.&lt;br /&gt;
# V6 morphology&lt;br /&gt;
#* RBBB-morphology - QS or rS favors VT. Although this can be influenced by axis (it is almost always seen in VT with left axis deviation, but is seen in only approximately 50% of VT with a normal axis, even in the same patient).&lt;br /&gt;
#* LBBB-morphology - a qR or QS is highly predictive of VT&lt;br /&gt;
# Capture beats. &amp;lt;br&amp;gt;&lt;br /&gt;
#* Occurs when a supraventricular impulse is conducted and captures the ventricle.&lt;br /&gt;
#* They are rare.&lt;br /&gt;
# Fusion beats. &amp;lt;br&amp;gt;&lt;br /&gt;
#* Rare in VT at a rapid rate.&amp;lt;ref&amp;gt;Chou&#039;s Electrocardiography in Clinical Practice Third Edition, pp. 398-409.&amp;lt;/ref&amp;gt; &amp;lt;ref&amp;gt;Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:194 ISBN 1591032016&amp;lt;/ref&amp;gt; &amp;lt;ref&amp;gt;Hammill S. C. Electrocardiographic diagnoses: Criteria and definitions of abnormalities, Chapter 18, MAYO Clinic, Concise Textbook of Cardiology, 3rd edition, 2007 ISBN 0-8493-9057-5&amp;lt;/ref&amp;gt;&lt;br /&gt;
&lt;br /&gt;
====Examples of Ventricular Tachycardia:====&lt;br /&gt;
&lt;br /&gt;
&amp;lt;div align=&amp;quot;left&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;gallery heights=&amp;quot;400&amp;quot; widths=&amp;quot;400&amp;quot;&amp;gt;&lt;br /&gt;
Image:Ganseman.VT1.jpg|12 lead EKG: Ventricular tachycardia. &lt;br /&gt;
Image:Ganseman.VT2.jpg|12 lead EKG: Ventricular tachycardia. &amp;lt;small&amp;gt; [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]&amp;lt;/small&amp;gt;&lt;br /&gt;
&amp;lt;/gallery&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&amp;lt;div align=&amp;quot;left&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;gallery heights=&amp;quot;400&amp;quot; widths=&amp;quot;400&amp;quot;&amp;gt;&lt;br /&gt;
Image:Ganseman.VT3.jpg|12 lead EKG: Ventricular tachycardia. &amp;lt;small&amp;gt; [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]&amp;lt;/small&amp;gt;&lt;br /&gt;
Image:Ganseman.VT4.jpg|12 lead EKG: Ventricular tachycardia. &amp;lt;small&amp;gt; [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]&amp;lt;/small&amp;gt;&lt;br /&gt;
&amp;lt;/gallery&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&amp;lt;div align=&amp;quot;left&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;gallery heights=&amp;quot;400&amp;quot; widths=&amp;quot;400&amp;quot;&amp;gt;&lt;br /&gt;
Image:Ganseman.VT5.jpg|12 lead EKG: Ventricular tachycardia. &amp;lt;small&amp;gt; [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]&amp;lt;/small&amp;gt;&lt;br /&gt;
Image:Ganseman.VT6.jpg|12 lead EKG: Ventricular tachycardia. &amp;lt;small&amp;gt; [http://www.ganseman.com/ecgbibnl.htm#_top000 Image courtesy of Dr Jose Ganseman]&amp;lt;/small&amp;gt;&lt;br /&gt;
&amp;lt;/gallery&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&amp;lt;div align=&amp;quot;left&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;gallery heights=&amp;quot;400&amp;quot; widths=&amp;quot;400&amp;quot;&amp;gt;&lt;br /&gt;
Image:12lead_vt1.jpg|Ventricular tachycardia of 140 bpm with a [[LBBB|left bundle branch block]] pattern and left heart axis.&lt;br /&gt;
Image:12lead_vt2.png|Ventricular tachycardia of 250 bpm with a [[RBBB|right bundle branch block]] pattern and right heart axis.&lt;br /&gt;
&amp;lt;/gallery&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
&lt;br /&gt;
&lt;br /&gt;
&amp;lt;div align=&amp;quot;left&amp;quot;&amp;gt;&lt;br /&gt;
&amp;lt;gallery heights=&amp;quot;400&amp;quot; widths=&amp;quot;400&amp;quot;&amp;gt;&lt;br /&gt;
Image:12lead_vt3.png|Ventricular tachycardia of 150 bpm with a [[RBBB|right bundle branch block]] pattern and right heart axis. Note the 5th and 6th complex from the right side. These are fusion complexes.&lt;br /&gt;
Image:ventricular_flutter_12lead.jpg|Ventricular flutter on a 12 lead ECG&lt;br /&gt;
&amp;lt;/gallery&amp;gt;&lt;br /&gt;
&amp;lt;/div&amp;gt;&lt;br /&gt;
&lt;br /&gt;
==References==&lt;br /&gt;
{{reflist|2}}&lt;br /&gt;
&lt;br /&gt;
[[Category: Electrophysiology]]&lt;br /&gt;
{{WH}}&lt;br /&gt;
{{WS}}&lt;/div&gt;</summary>
		<author><name>Avirupguha</name></author>
	</entry>
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