Is the routine implantation of an implantable cardioverter defibrillator (ICD) in myocardial infarction survivors with heart failure still an adequate therapy for prevention of sudden cardiac death?
Reviewed by Danielle Ellis, B.Sc.Aug 28 2023 The PROFID EHRA trial is set to answer this question in a large, multicentre, EU-funded study set to enroll the first patient this summer. The consortium of partners and colleagues involved in the trial, including the European Heart Rhythm Association of the European Society of Cardiology , will meet during ESC Congress 2023 to discuss the start of the study.
In the last two decades, the medical management of patients with severely reduced LVEF has improved dramatically. Novel drugs were introduced that lower the risk of sudden cardiac death. As a result, rates of sudden cardiac death in patients with heart failure have declined and the delivery of life-saving ICD shocks has reduced. Therefore, the risk-benefit ratio of routine prophylactic defibrillator implantation in these patients warrants reassessment.
The hypothesis of the trial is that in post-myocardial infarction patients with symptomatic heart failure and reduced LVEF , optimal medical therapy without ICD implantation is not inferior to optimal medical therapy with ICD implantation with respect to all-cause death within around 2.5 years of follow up.