the sudden cardiac death in heart failure trial (SCD-HeFT) The Question Heart failure is a progressive disease in which patients may die suddenly due to arrhythmia, or problems that affect the electrical system of the heart muscle. Available treatment options have been limited to anti-arrhythmic drugs and implantable cardioverter-defibrillator devices (ICDs). Is the use of an ICD or amiodarone (an anti-arrhythmic drug) effective in treating heart failure patients who are also receiving standard medical therapy? This Study SCD-HeFT, the largest ICD trial ever, studied 2,521 patients from 148 centers across the United States, Canada and New Zealand. All patients suffered from moderate heart failure and had poor cardiac pumping function. Patients were assigned three groups: 1) ICD therapy, 2) drug (amiodarone) therapy, and 3) placebo. The study showed that ICDs reduced death by 23 percent in people with moderate heart failure compared to those who did not receive defibrillators. The study also showed that amiodarone, when used as a preventative medication, does not improve survival. Conclusion People with moderate heart failure live longer when they receive an implantable cardioverter-defibrillator. Who may be affected by these findings? Five million Americans suffer from heart failure. People with this condition suffer sudden cardiac arrest – a condition that kills more than 400,000 Americans each year – at a rate 6-9 times that of the general population. Caveats For the very aged or very sick, ICD therapy may not translate into a meaningful extension of life and may complicate end-of-life measures. The broad sweeping implications to be considered by physicians, third-party payers, and regulatory agencies must include the significant healthcare costs associated with implementation of ICD therapy in several million Americans living with heart failure. Find this Study www.sicr.org Sponsor and Presentation National Institutes of Health; Wyeth-Ayerst, Medtronic. Presented at the American College of Cardiology Scientific Sessions in March of 2004.