Sudden cardiac death primary prevention trials Trial (year reported) Population Additional risk markers MADIT (1996) (20) 196 patients with MI longer Asymptomatic NSVT with than 3 weeks before entry inducible VT not and LVEF suppressed by IV [less than or equal to] procainamide 0.
As a result of these landmark findings from MADIT and other studies, the American College of Cardiology, the North American Society of Pacing and Electrophysiology, and the American Heart Association issued joint guidelines calling for expanded use of ICDs for the primary prevention of sudden cardiac death.
The results of the MADIT II clinical trial, published earlier this year in the New England Journal of Medicine, demonstrated that placement of an ICD in patients with a prior myocardial infarction and a left ventricular ejection fraction of 30% or less resulted in a 5.
While many studies over the years have demonstrated the benefits of ICDs, the MADIT II trial of 1,232 patients convincingly showed the benefits of ICDs implanted in patients who had a prior heart attack and an ejection fraction of less than 30 percent.
For example, evidence from MADIT II (the second Multicenter Automatic Defibrillator Implantation Trial) elevated the recommendation--that implantable cardiac defibrillators (ICDs) be used for primary prevention of sudden cardiac arrest in patients who have ischemic cardiomyopathy due to prior MI, have a left ventricular ejection fraction of less than 30%, and are New York Heart Association functional class I--from a class IIa recommendation ("it is reasonable") to a class I recommendation (it "should be performed/administered").