Defibrillators Best Bet for Patients With Severe Heart Rhythm Irregularities
Dec. 15, 1999 (Atlanta) -- Defibrillators -- devices implanted into the
chest that shock the heart into a normal rhythm -- are much more effective than
medication at preventing sudden death in patients with heart rhythm
irregularities, according to a study published in the latest issue of
TheNew England Journal of Medicine.
"The trial wasn't designed to determine whether defibrillators were
better than drugs," says lead author Alfred E. Buxton, MD. "We didn't
suspect that there would be any significant difference in the outcome of
patients who were treated with drugs vs. defibrillators, but it's a 32%
difference over 5 years."
According to Buxton, who is professor of medicine and director of the
electrophysiology lab and arrhythmia services at Brown University School of
Medicine, the findings "give us a lot more stable information on which to
base patient management decisions."
U.S. and Canadian researchers studied more than 704 heart failure patients
who were at risk for potentially fatal heart irregularities, called
arrhythmias, due to blockages in the arteries that supply blood to the heart.
The patients either received medication or no treatment, or had a defibrillator
The risk of death or cardiac arrest from arrhythmia was 27% lower for those
treated with medication than for those who received no drugs. Defibrillators
reduced the 5-year risk of cardiac arrest the most.
This study has significant implications for treating patients with
potentially fatal heart irregularities. Buxton says that the data "tell us
we can't rely on" medication for treating these types of arrhythmias.
Considering that the study "was designed to mirror what has been, until
very recently, current practice," Buxton says his team was
"surprised" by the results, which should change the standard of care.
Buxton does stress that patients and physicians must realize that these results
apply only to patients in whom blocked arteries are responsible for heart
- Defibrillators are devices implanted into the chest that shock the heart
back into a normal rhythm when it becomes irregular.
- In patients who have arrhythmia caused by blocked arteries that supply the
heart, implantable defibrillators are much more effective in preventing sudden
death than medications.
- Researchers are surprised by the results and suggest that the findings
could change the standard of care.