Surgically implanting the heart-shocking devices known as defibrillators in people who have had heart attacks prevented sudden death in nearly one-third of the patients. Doctors say the findings will likely lead to a dramatic and costly shift in the way they treat millions of heart attack patients by adding a $20,000 defibrillator to the medicines now in use.
The study is the first to test the preventive use of these devices in people without apparent rhythm problems, but whose hearts are so scarred from heart attacks that they pump half the normal amount of blood. Implantable defibrillators were designed to prevent sudden death in people with a severe, life-threatening ventricular fibrillation, in which the heart quivers and can't pump blood.
The new study involved 2,008 patients, half of whom received an implantable defibrillator. The other half received conventional drug therapy. Over 20 months, defibrillators cut the risk of death by 31%, compared with drug therapy. David Faxon, president of the American Heart Association, called the device's benefit "substantial," but added, "It's too soon to make sweeping recommendations without taking into account the increased costs and complications."