OBJECTIVES: The aim of this study was to compare the effectiveness of the @entity737 ( @entity737 ) and medical strategies for prevention of arrhythmic events and @entity204 . BACKGROUND: The @entity737 is a potential strategy to reduce mortality in @entity1 at risk of @entity944 . METHODS: The MEDLINE, EMBASE, and Cochrane Library electronic databases were searched from January 1966 to April 2002. All published randomized controlled trials comparing @entity737 implantation with medical therapy were reviewed. Four independent reviewers extracted data on all-cause mortality, @entity204 , and @entity204 using a standardized protocol. RESULTS: Nine studies including over 5,000 @entity1 were synthesized using both fixed-effects and random-effects models. The primary and secondary prevention trials showed a significant benefit of the @entity737 with respect to @entity204 , with relative risks (RR) of 0.34 and 0.50, respectively (both p < 0.001). The mortality benefit of the @entity737 was entirely attributable to a reduction in @entity204 (all trials: p < 0.00001). Whereas the secondary prevention trials exhibited a robust decrease in all-cause @entity737 mortality (RR 0.75; p < 0.001), the pooled primary prevention trials demonstrated decreased all-cause @entity737 mortality (RR 0.66; p < 0.05) which was dependent on selected individual trials. The disparity in @entity737 -related mortality reductions in the primary prevention trials was related to variability in the incidence of @entity204 between individual studies. CONCLUSIONS: Although the @entity737 decreases the risk of @entity204 , its impact on all-cause mortality is related to the underlying risk of @entity943 -related @entity204 relative to competing causes. Given the cost of the device strategy, policies of targeted intervention based on the future risk of @entity943 are warranted.

Effectiveness of implantable defibrillators for preventing arrhythmic events and XXXX : a meta-analysis.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity943 :: ('MESH:D001145', 'Disease') :: ['arrhythmia'] @entity944 :: ('MESH:D003645', 'Disease') :: ['sudden death'] @entity737 :: ('MESH:D057873', 'Disease') :: ['ICD', 'implantable cardioverter defibrillator'] @entity204 :: ('MESH:D003643', 'Disease') :: ['nonarrhythmic death', 'arrhythmic death', 'death']
@entity204 :: (MESH:D003643,Disease) :: ['death']
