Europace Advance Access originally published online on March 26, 2008
Europace 2008 10(5):536-539; doi:10.1093/europace/eun070
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ICDs
Implantable cardioverter defibrillator following acute myocardial infarction: the 48-hour and 40-day rule
1 University Department of Medicine, City Hospital, Birmingham B18 7QH, UK; 2 Cardiology Division, Department of Medicine, The University of Hong Kong, Hong Kong, China
Until recently, randomized studies of implantable cardioverter defibrillator (ICD) have only included patients with a remote history of myocardial infarction (MI). Two studies evaluated the use of ICDs early following MI, the DINAMIT and BEST+ICD studies, but failed to demonstrate significant reduction in mortality. Current guidelines therefore recommend deferring ICD implantation for at least 40 days following MI. This article highlights the limitations of these two studies and reviews the application of the 40-day rule to patients with acute MI.
Key Words: Implantable cardioverter defibrillator, Acute myocardial infarction
* Corresponding author. Tel: +44 121 507 5080; fax: +44 121 554 4083. E-mail address: hsern{at}doctors.net.uk
Manuscript submitted 28 January 2008. Accepted after revision 28 February 2008.