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MAVERICMidlands trial of empirical Amiodarone Versus Electro-physiologically guided Intervention and Cardioverter implant. A trial that asked whether patients who might benefit from an implantable cardioverter-defibrillator (ICD) could be identified prospectively by electrophysiology (EP) studies—and if so, would implanted ICDs prevent sudden cardiac death (SCD)—comparing EP-guided interventions (anti-arrhythmic drugs, coronary revascularisation and ICD) to empirical amiodarone therapy.
No. Prospective selection of patients to receive the ICD by EP study did not improve survival compared to empirical amiodarone therapy among survivors of ventricular tachycardia, ventricular fibrillation or SCD; ICD implantation improved survival regardless of treatment. Routine EP studies have no role in managing such patients, who should be offered empirical ICD therapy according to the results of other secondary prevention ICD trials.