Role of implantable cardioverter defibrillators in non-ischaemic dilated cardiomyopathy.

Scott, Paul A; Roberts, Paul R · Postgrad Med J · 2010

review · Level V

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Abstract

Patients with non-ischaemic dilated cardiomyopathy (NICM) are at significant risk of sudden cardiac death. Multiple randomised trials have shown that implantable cardioverter defibrillators (ICDs) reduce mortality in high-risk patients with NICM. However, despite this, the National Institute for Health and Clinical Excellence specifically excluded patients with NICM from its updated guidance concerning ICD use. This lack of guidance poses clear problems for both clinicians managing patients with NICM and those who commission healthcare services. This review aims to help guide clinicians in this difficult, high-cost and high-risk area.

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