HealthDay News — Rates of sudden death from heart failure have declined by nearly half over the past 2 decades, according to research published in the New England Journal of Medicine.

John McMurray, MD, a professor of cardiology with the University of Glasgow in the United Kingdom, and colleagues analyzed data on 40,195 heart failure patients enrolled in 12 clinical trials conducted between 1995 and 2014.

The combined data from the clinical trials showed that sudden death rates have fallen by 44% in heart failure patients who have not received an implantable cardioverter-defibrillator (ICD). The researchers also found that the rate of sudden death was not higher among newly diagnosed heart failure patients.

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“Our findings add to the recent debate about who should get an ICD given that these are expensive devices, the implantation of which can be associated with complications,” McMurray told HealthDay. “The majority of patients receiving an ICD never use it. So, while everyone agrees that ICDs are a valuable and lifesaving treatment, we haven’t yet worked out who most needs and benefits from an ICD — ie, how to target ICDs to the highest-risk patients.”

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Shen L, Jhund PS, Petrie MC. Declining risk of sudden death in heart failure. N Engl J Med. 2017 Jul 6;377(1):41-51. doi: 10.1056/NEJMoa1609758.