Patients with non-ischaemic dilated cardiomyopathy (NICM) are at significant risk of sudden cardiac death. Multiple randomised trials have shown that implantable cardioverter defibrillators (ICDs) reduce mortality in high-risk patients with NICM. However, despite this, the National Institute for Health and Clinical Excellence specifically excluded patients with NICM from its updated guidance concerning ICD use. This lack of guidance poses clear problems for both clinicians managing patients with NICM and those who commission healthcare services. This review aims to help guide clinicians in this difficult, high-cost and high-risk area.
- Dilated cardiomyopathy
- sudden death
- ventricular arrhythmias
- implantable cardioverter defibrillators
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Competing interests PAS is supported by an educational grant from Medtronic. PRR has received honoraria and research grants from Medtronic, St Jude, Sorin and Boston Scientific.
Provenance and peer review Not commissioned; externally peer reviewed.