Abstract
The Madit trial1 showed that implantation of a cardioverter defibrillator (ICD) in patients at risk of post-myocardial infarction ventricular tachyarrhythmias and their implicit further risk of sudden death was significantly more effective in preventing the latter than receiving “conventional” medical therapy. The problem resides in the definition of what was conventional treatment in Madit, and its potential differences with any better, if not best, medical therapy. However the main, if not the only, problem with Madit clearly is that the conventional treatment utilised in non-implanted patients was much less than optimal, whereas implanted patients benefited after all from better conditions. This may explain why the difference between the two groups became significant after a 27-month follow-up. However, this does not exclude the fact that implanted defibrillation cannot improve the performances of presently available better therapies than those used in Madit. Many problems evoked below were discussed in an excellent editorial published together with the original article2.
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© 1998 Springer Science+Business Media Dordrecht
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Coumel, P. (1998). The Madit Trial: What was Wrong?. In: Vardas, P.E. (eds) Cardiac Arrhythmias, Pacing & Electrophysiology. Developments in Cardiovascular Medicine, vol 201. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-5254-9_17
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DOI: https://doi.org/10.1007/978-94-011-5254-9_17
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-010-6210-7
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