Antiarrhythmics versus implantable defibrillators

Following resuscitation from ventricular fibrillation (VF) or pulseless VT, ICD implantation is a proven strategy for the prevention of recurrent SCD. Three prospective, randomized, controlled trials, the Antiarrhythmics Versus Implantable Defibrillators (AVID) study, the Canadian Implantable Defibrillator Study (CIDS), and the Cardiac Arrest Study Hamburg (CASH), support this strategy [27-29]. 

A comparison of antiarrhythmic-drug therapy with implantable defibrillators in patients resuscitated from near-fatal ventricular arrhythmias. The antiarrhythmics versus implantable defibrillators (AVID) investigators. NEnglJMed. Nov 27 1997 337(22) 1576-1583. 

Schron EB, Exner DV, Yao Q, et al. Quality of life in the antiarrhythmics versus implantable defibrillators trial impact of therapy and influence of adverse symptoms and defibrillator shocks. Circulation. Feb 5 2002 105(5) 589-594. 

Exner, D., Reiffel, J., Epstein, A., Ledingham, R., Reiter, M., Yao, Q., Duff, H., Follmann, D., Schron, E., Greene, H., Carlson, M., Brodsky, M., Akiyama, T., Baessler, C., and Anderson, J., Beta-blocker use and survival in patients with ventricular fibrillation or symptomatic ventricular tachycardia The Antiarrhythmics Versus Implantable Defibrillators (AVID) trial, Journal of American College of Cardiology, Vol. 34, No. 2, 1999, pp. 325-333. 

The Antiarrhythmics versus Implantable Defibrillators (AVID) trial (7) was the largest secondary prevention trial, and helped define ICD implant indications for patients with a history of ventricular arrhythmias. In AVID, 1013 patients who presented with VF, sustained VT with syncope, or sustained VT with a LVEF of <40% were randomized to either an ICD or antiarrhythmic... 

Domanski MJ, Sakseena S, Epstein AF, et al. Relative effectiveness of the implantable cardioverter-defibrillator and antiarrhythmic drugs in patients with varying degrees of left ventricular dysfunction who have survived malignant ventricular arrhythmias. AVID investigators. Antiarrhythmics Versus Implantable Defibrillators. J Am Coll Cardiol 1999 34(4) 1090-5. 

Antiarrhythmics versus Implantable Defibrillators (AVID) Investigators. N Engl JMed 1997 337 1576-83. 

AVID (antiarrhythmics versus implantable defibrillator, 1997) ICD vs. amiodarone/sota-lol for VTA F CAD (81%), prior MI (67%) l,016pts Cardiac arrest sustained VT with syncope or snstained VT with EF < 40% and symptomatic because of hemodynamic compromise from the arrhythmia... 

Akiyama T, Powell JL, Mitchell LB, Baessler C. Antiarrhythmics versus Implantable Defibrillators Investigators. Resumption of driving after life-threatening ventricular tachyarrhythmia. N Engl J Med. 2001 Aug 9 345(6) 391-397. 

The Canadian Implantable Defibrillator Study studied ICD therapy versus amiodarone while CASH studied ICD therapy versus a variety of antiarrhythmic medications in patients with resuscitated SCD. Both trials found nonsignificant reductions in mortality with ICD implantation. CIDS showed a relative risk (RR) reduction of 19.7% [p = 0.14] and CASH showed a RR reduction of 23% in mortality [p = 0.08]. 

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