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 implanted.
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 failure.
- 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.