MADIT II is changing sudden cardiac death (SCD) prevention in patients with prior myocardial infarction (MI). The inclusion criteria for MADIT II have far-reaching implications with regard to the benefits of prophylactic ICD therapy for post-MI patients.
By applying MADIT II inclusion criteria to ICD screening practices, the opportunity exists to substantially decrease SCD rates among post-MI patients with an ejection fraction (EF) <30%.1
Put into practice, MADIT II inclusion criteria can decrease mortality in post-myocardial infarction (MI) patients with an EF <30%. The novel design and landmark results of MADIT II provide an algorithm for ICD treatment practices:
Post-MI patients with an EF <30% are at risk for sudden cardiac death (SCD).1 MADIT II was designed to study prophylactic ICD therapy in this patient population. Patient eligibility for MADIT II included MI at least 30 days prior to enrollment, and an EF <30%.
There was no requirement for premature ventricular contractions (PVCs) or for patients to undergo electrophysiology testing for arrhythmia markers.1 Both male and female patients over 21 years of age participated in the study. MADIT II did not test patients for risk stratification or utilize upper-age limitation.1
Inclusion criteria for MADIT II, in conjunction with trial results, demonstrate that post-MI patients are indicated for prophylactic ICD therapy based on an EF <30%.1
With the straightforward inclusion criteria of prior MI and an EF <30%, the results of MADIT II demonstrated a 31% reduction in the risk of death for ICD patients versus patients treated with conventional medical therapy alone.