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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
12
pubmed:dateCreated
2005-6-13
pubmed:abstractText
We compared 2 studies of implantable cardiac defibrillators (ICDs) to determine the effects of device mode on outcomes. The Antiarrhythmics Versus Implantable Defibrillators (AVID) trial (1993 to 1997) demonstrated improved survival with the ICD compared with antiarrhythmic drug therapy. The Dual-chamber And VVI Implantable Defibrillator (DAVID) trial (2000 to 2002) showed that VVI pacing at 40 beats/min in patients with ICDs reduced the combined end point of death and hospitalization for congestive heart failure compared with DDDR pacing at 70 beats/min. Patients in the AVID trial (631 of 1,016) and the DAVID trial (221 of 506) meeting common inclusion and all exclusion criteria were studied. The major end points were the time to death, and the composite end point of time to death or hospitalization for congestive heart failure. Patients in the AVID and DAVID trials were similar, but more AVID patients had coronary artery disease (p = 0.04), history of myocardial infarction (p = 0.005), and previous ventricular arrhythmias (p = 0.03). DAVID patients underwent more previous revascularization procedures (coronary artery bypass surgery, p = 0.03; percutaneous coronary intervention, p = 0.001), and were more often taking beta-blocking drugs at hospital discharge (p <0.001). The backup VVI ICD groups in both studies had similar outcomes (p = 0.4), even when corrected for the previous demographic differences. The time-to- composite end point was similar in AVID patients treated with antiarrhythmic drugs and DAVID patients treated with DDDR ICDs (p = 0.6). Despite improved pharmacologic therapy and revascularization, outcomes have not improved with backup VVI pacing ICDs. If DDDR ICDs had been used in the AVID trial, benefit from ICDs for patients with serious ventricular arrhythmias could have been missed.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jun
pubmed:issn
0002-9149
pubmed:author
pubmed:issnType
Print
pubmed:day
15
pubmed:volume
95
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1431-5
pubmed:dateRevised
2007-11-15
pubmed:meshHeading
pubmed-meshheading:15950565-Adrenergic beta-Antagonists, pubmed-meshheading:15950565-Aged, pubmed-meshheading:15950565-Amiodarone, pubmed-meshheading:15950565-Anti-Arrhythmia Agents, pubmed-meshheading:15950565-Cardiac Pacing, Artificial, pubmed-meshheading:15950565-Defibrillators, Implantable, pubmed-meshheading:15950565-Equipment Design, pubmed-meshheading:15950565-Female, pubmed-meshheading:15950565-Follow-Up Studies, pubmed-meshheading:15950565-Heart Failure, pubmed-meshheading:15950565-Hospitalization, pubmed-meshheading:15950565-Humans, pubmed-meshheading:15950565-Male, pubmed-meshheading:15950565-Prospective Studies, pubmed-meshheading:15950565-Randomized Controlled Trials as Topic, pubmed-meshheading:15950565-Survival Rate, pubmed-meshheading:15950565-Tachycardia, Ventricular, pubmed-meshheading:15950565-Treatment Outcome
pubmed:year
2005
pubmed:articleTitle
A comparison of the AVID and DAVID trials of implantable defibrillators.
pubmed:affiliation
Mercy Hospital, Sacramento, California 95819,USA. asharma@rcamd.com
pubmed:publicationType
Journal Article, Comparative Study, Research Support, Non-U.S. Gov't