Preventive implantable cardioverter defibrillator therapy in contemporary clinical practice: need for more stringent selection criteria.

9 In MUSTT, with EF ≤ 40% as LV function inclusion criterion, the relation between EF and event rates was highly significant whether EF was treated as continuous or dichotomized variable, and total mortality in patients with EF ≤ 30% was more than 50% higher compared with EF between 30% and 40%. 37 Of course, sudden arrhythmic death will continue to occur, but—given the currently available therapeutic options—at a much lower rate than observed in the landmark and other trials. 11 The conclusion that this affects ICD therapy effectiveness is not new and has led to multiple attempts to identify patients at highest risk.

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