Effectiveness of Implantation of Cardioverter-Defibrillators Therapy in Patients with Non-Ischemic Heart Failure: an Updated Systematic Review and Meta-Analysis

Abstract Objective: Implantable cardioverter-defibrillator has become the first-line therapy for prevention of sudden cardiac death. Controversial results still exist regarding the effectiveness of implantable cardioverter-defibrillator (ICD) in non-ischemic heart failure. Methods: The PubMed, Embase, and Cochrane Central databases were searched for randomized trials comparing implantable cardioverter-defibrillator in combination with medical treatment versus medical treatment for non-ischemic heart failure. The primary endpoint was incidence of all-cause death. We derived pooled risk ratios with fixed-effects models. Results: Five studies enrolling 2573 patients were included. Compared with medical treatment, implantable cardioverter-defibrillator with medical treatment was associated with a significantly lower risk for all-cause mortality (Risk ratio: 0.83; 95% confidence interval 0.71 to 0.97). Conclusion: Compared with medical treatment only, implantable cardioverter-defibrillator in combination with medical treatment reduces all-cause mortality.