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Debate: Do all patients with heart failure require implantable defibrillators to prevent sudden death?

Published by National Institutes of Health | U.S. Department of Health & Human Services | Metadata Last Checked: September 08, 2025 | Last Modified: 2025-09-06
Sudden death is a major cause of mortality in patients with ventricular dysfunction. The highest risk occurs among patients with less severe functional impairment. Current methods of risk stratification are inadequate, and a rational therapy for prevention of sudden death is not available. The implantable cardioverter-defibrillator (ICD) has proven to be more effective than drugs in reducing sudden-death risk in some subsets of patients. Empiric ICD therapy, targeting the general population with mild to moderate heart failure, will maximize the impact of such a strategy to prevent sudden death and improve long-term survival.

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