ABSTRACT
Congestive heart failure (CHF) results from a variety of different diseases affecting the ventricular myocardium. Left ventricular (LV) remodeling occurs, and ultimately, systolic dysfunction ensues with symptoms relating to elevated LV diastolic filling pressures and diminished cardiac output. Despite decongestive therapy and neuro-hormonal modification, morbidity and mortality remain high. Heart failure hospitalizations make up approximately 20% of all hospitalizations of people over the age of 65. Moreover, CHF patients are at a higher risk of malignant arrhythmias and sudden cardiac death. Several randomized controlled trials have demonstrated that ICDs reduce mortality related to the decreased risk of sustained ventricular arrhythmia. However, ICDs do not prevent CHF exacerbations, and nor do they improve symptoms independent of medical therapy.
