These May Help People With Moderate Heart Failure
Devices could extend life and bolster guidelines for their use, researchers say
"The absolute benefit is much greater in those with ejection fractions of less than 30 percent than for those between 30 and 35 percent, but statistical benefit still exists," he said.
When discussing these benefits with patients, doctors need to have an honest discussion about the magnitude of benefit, Henry said.
Even patients who have severely decreased function have to be told that, on average, 45 percent will die within three years even with an implanted defibrillator, he said.
"We are making a modest impact with our interventions, but outcomes are still sobering, and we need to continue to focus our efforts on prevention," Henry said.
For the study, researchers studied 3,120 patients with ejection fractions of 30 percent to 35 percent, comparing deaths among those who had implanted defibrillators with those who did not.
They repeated their analysis among 4,578 patients with ejection fractions of less than 30 percent.
The researchers found that survival of heart failure patients with ejection fractions of 30 percent to 35 percent improved in those with implanted defibrillators, compared with those without them. The death rate at three years dropped from 55 percent to 51.4 percent when a defibrillator was implanted, they noted.
Implanted defibrillators were associated with even greater increases in survival among heart failure patients with ejection fractions of less than 30 percent. Among these patients, three-year death rates dropped from almost 58 percent to 45 percent with implantable defibrillator use, the researchers found.
Dr. Todd Cohen, director of the pacemaker-arrhythmia center at the Winthrop-University Hospital in Mineola, N.Y., said that an earlier study had shown improved survival with an implantable defibrillator in patients with mild to moderate congestive heart failure and an ejection fraction of less than or equal to 35 percent.
"This new study gives additional support for defibrillator implantation according to the approved guidelines," he said.