Solomon SD, Zelenkofske S, McMurray JJ, et al; Valsartan in Acute Myocardial Infarction Trial (VALIANT) Investigators. Sudden death in patients with myocardial infarction and left ventricular dysfunction, heart failure, or both. N Engl J Med. 2005;352:2581-2588.
Pouleur AC, Barkoudah E, Uno H, et al. Pathogenesis of sudden unexpected death in a clinical trial of patients with myocardial infarction and left ventricular dysfunction, heart failure, or both. Circulation. 2010; 122:597-602.
Dorian P, Hohnloser SH, Thorpe KE, et al. Mechanisms underlying the lack of effect of implantable cardioverter-defibrillator therapy on mortality in high-risk patients with recent myocardial infarction: insights from the Defibrillation in Acute Myocardial Infarction Trial (DINAMIT). Circulation. 2010;122:2645-2652.
Steinbeck G, Andresen D, Seidl K, et al; IRIS Investigators. Defibrillator implantation early after myocardial infarction. N Engl J Med. 2009; 361:1427-1436.
Bigger JT Jr. Prophylactic use of implanted cardiac defibrillators in patients at high risk for ventricular arrhythmias after coronary-artery bypass graft surgery. Coronary Artery Bypass Graft (CABG) Patch Trial Investigators. N Engl J Med. 1997;337:1569-1575.
Hauptman PJ, Swindle JP, Masoudi FA, et al. Underutilization of beta-blockers in patients undergoing implantable cardioverter-defibrillator and cardiac resynchronization procedures. Circ Cardiovasc Qual Outcomes. 2010; 2:204-211.
Pitt B, Williams G, Remme W, et al. The EPHESUS trial: eplerenone in patients with heart failure due to systolic dysfunction complicating acute myocardial infarction. Eplerenone Post-AMI Heart Failure Efficacy and Survival Study. Cardiovasc Drugs Ther 2001;15:79-87.
Poole-Wilson PA, Uretsky BF, Thygesen K, Cleland JG, Massie BM, Rydén L; Atlas Study Group. Assessment of treatment with lisinopril and survival. Mode of death in heart failure: findings from the ATLAS trial. Heart. 2003;89: 42-48.
Centers for Medicare and Medicaid Services. Department of Health and Human Services. CMS Manual System, Pub. 100-03 Medicare National Coverage Determinations. Available at: http://www.cms.gov/transmittals/downloads/R29NCD.pdf. Published March 4, 2005. Accessed April 11, 2013.
Russo AM, Stainback RF, Bailey SR, et al. ACCF/HRS/AHA/ASE/HFSA/SCAI/SCCT/SCMR 2013 Appropriate Use Criteria for Implantable Cardioverter-Defibrillators and Cardiac Resynchronization Therapy: A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, Heart Rhythm Society, American Heart Association, American Society of Echocardiography, Heart Failure Society of America, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance. J Am Coll Cardiol. 2013;61:1318-1368.
Zipes DP, Camm AJ, Borggrefe M, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death) developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006;114:e385-e484.
Bardy GH, Lee KL, Mark DB, et al; HAT Investigators. Home use of automated external defibrillators for sudden cardiac arrest. N Engl J Med. 2008;358:1793-1804.
Kadish A, Dyer A, Daubert JP, et al. Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. Defibrillators in Non-Ischemic Cardiomyopathy Treatment Evaluation (DEFINITE) Investigators. N Engl J Med. 2004;350:2151-2158.
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CME / CE

Addressing the Risk for Sudden Cardiac Death in Heart Failure

Authors: Scott D. Solomon, MD; Philip B. Adamson, MD; Paul Hauptman, MD
CME / CE Released: 4/30/2013; Reviewed and Renewed: 9/2/2015
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 9/2/2016, 11:59 PM EST

Target Audience and Goal Statement

This activity is intended for electrophysiologists, interventional cardiologists, cardiac surgeons, general cardiologists, internists, critical care specialists, cardiology nurses, and other allied healthcare professionals.

The goal of this activity is to provide strategies with clinical tools and techniques to appropriately risk stratify and optimize primary prevention strategies for patients at high risk of sudden cardiac death.

Upon completion of this activity, participants will be able to:

Identify persistent treatment gaps within the heart failure population
Evaluate potential mechanisms underlying the risk for sudden death and heart failure
Assess the role of implantable and wearable cardiac defibrillators to address the risk of sudden cardiac death in patients with ischemic and nonischemic heart failure

Disclosures

As an organization accredited by the ACCME, Medscape, LLC, requires everyone who is in a position to control the content of an education activity to disclose all relevant financial relationships with any commercial interest. The ACCME defines "relevant financial relationships" as financial relationships in any amount, occurring within the past 12 months, including financial relationships of a spouse or life partner, that could create a conflict of interest.

Medscape, LLC, encourages Authors to identify investigational products or off-label uses of products regulated by the US Food and Drug Administration, at first mention and where appropriate in the content.

Moderator

Scott D. Solomon, MD

Professor of Medicine, Harvard Medical School; Director, Noninvasive Cardiology; Director, Cardiac Imaging Core Laboratory and Clinical Trials Endpoints Center, Brigham and Women’s Hospital, Boston, Massachusetts

Disclosures

Disclosure: Scott D. Solomon, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Novartis Pharmaceuticals Corporation; Sanofi; Zoll Medical Corporation; Amgen Inc.; Abbott Laboratories; Theracos, Inc.; GlaxoSmithKline; Sandoz
Received grants for clinical research from: Sanofi; Amgen Inc.; Novartis Pharmaceuticals Corporation; Abbott Laboratories; Boston Scientific

Dr Solomon does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Solomon does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Panelists

Philip B. Adamson, MD

Director, Heart Failure Institute at Oklahoma Heart Hospital; Director, Oklahoma Foundation for Cardiovascular Research; Adjunct Associate Professor of Physiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma

Disclosures

Disclosure: Philip B. Adamson, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Medtronic, Inc.; St. Jude Medical; CardioMEMS; Cardiologic Innovations, CVRx, Inc.; Sensible Medical Innovations
Served as a speaker or a member of a speakers bureau for: Medtronic, Inc.; St. Jude Medical; CardioMEMS; Cardiologic Innovations; CVRx, Inc.; Sensible Medical Innovations; Actelion Pharmaceuticals, Ltd.

Dr Adamson does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Adamson does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Paul Hauptman, MD

Professor of Internal Medicine, Division of Cardiology; Assistant Dean, Clinical and Translational Research, Saint Louis University School of Medicine, St. Louis, Missouri

Disclosures

Disclosure: Paul Hauptman, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: BioControl Medical; Otsuka Pharmaceutical Co., Ltd.
Served as a speaker or a member of a speakers bureau for: Otsuka Pharmaceutical Co., Ltd.
Received grants for clinical research from: Celladon

Dr Hauptman does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the United States.

Dr Hauptman does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

Editor

Ronald K. Miller, PhD

Scientific Director, Medscape, LLC

Disclosures

Disclosure: Ronald K. Miller, PhD, has disclosed no relevant financial relationships.

Acute MI Steering Committee

Deepak L. Bhatt, MD, MPH

Chief of Cardiology, VA Boston Healthcare System; Senior Physician, Brigham and Women's Hospital; Professor of Medicine, Harvard Medical School; Senior Investigator, TIMI Study Group, Boston, Massachusetts

Disclosures

Disclosure: Deepak L. Bhatt, MD, MPH, has disclosed the following relevant financial relationships:
Received grants for clinical research from: AstraZeneca Pharmaceuticals LP; Bristol-Myers Squibb Company; Eisai Inc.; Ethicon, Inc.; Medtronic, Inc.; sanofi-aventis; The Medicines Company; Medtronic, Inc.

Roberta C. Bogaev, MD

Assistant Professor of Medicine, Baylor College of Medicine, Houston, Texas; Private Practice Cardiologist, Schnitzler Cardiovascular Consultants, San Antonio, Texas

Disclosures

Disclosure: Roberta C. Bogaev, MD Roberta C. Bogaev, MD, has disclosed no relevant financial relationships.

Ted E. Feldman, MD

Professor of Medicine, Northwestern University School of Medicine, Evanston, Illinois

Disclosures

Disclosure: Ted E. Feldman, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Abbott Laboratories; Boston Scientific; Coherex Medical, Inc.; Edwards Lifesciences; Intervalve; Daiichi Sankyo, Inc.; Eli Lilly and Company; W.L. Gore & Associates, Inc.
Served as a speaker or a member of a speakers bureau for: Boston Scientific Received grants for clinical research from: Abbott Laboratories; Boston Scientific; Edwards Lifesciences; St. Jude Medical; W.L. Gore & Associates, Inc.

Jagmeet P. Singh, MD, PhD

Associate Professor of Medicine, Cardiac Arrhythmia Service, Massachusetts General Hospital Heart Center, Harvard Medical School, Boston, Massachusetts

Disclosures

Disclosure: Jagmeet P. Singh, MD, PhD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: BIOTRONIK; Boston Scientific; Medtronic, Inc.; St. Jude Medical; Sorin Group; CardioInsight Technologies Inc.; Thoratec Corporation
Served as a speaker or a member of a speakers bureau for: BIOTRONIK; Boston Scientific; St. Jude Medical; Sorin Group
Received grants for clinical research from: BIOTRONIK; Boston Scientific; St. Jude Medical; Sorin Group; Medtronic, Inc.

CME Reviewer

Nafeez Zawahir, MD

CME Clinical Director, Medscape, LLC

Disclosures

Disclosure: Nafeez Zawahir, MD, has disclosed no relevant financial relationships.

Nurse Planner

Laurie E. Scudder, DNP, NP

Nurse Planner, Continuing Professional Education Department, Medscape, LLC; Clinical Assistant Professor, School of Nursing and Allied Health, George Washington University, Washington, DC

Disclosures

Disclosure: Laurie E. Scudder, DNP, NP, has disclosed no relevant financial relationships.

Accreditation Statements

For Physicians

Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Medscape, LLC designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit(s)™ . Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Medscape, LLC staff have disclosed that they have no relevant financial relationships.

Contact This Provider

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Awarded 0.50 contact hour(s) of continuing nursing education for RNs and APNs; none of these credits is in the area of pharmacology.

Accredited status does not imply endorsement by Medscape, LLC or ANCC of any commercial products discussed in conjunction with the educational activity.

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From Medscape Education Cardiology

CME / CE

Addressing the Risk for Sudden Cardiac Death in Heart Failure

Authors: Scott D. Solomon, MD; Philip B. Adamson, MD; Paul Hauptman, MDFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CME / CE Released: 4/30/2013; Reviewed and Renewed: 9/2/2015

Valid for credit through: 9/2/2016, 11:59 PM EST

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The educational activity presented above may involve simulated case-based scenarios. The patients depicted in these scenarios are fictitious and no association with any actual patient is intended or should be inferred.

The material presented here does not necessarily reflect the views of Medscape, LLC, or companies that support educational programming on medscape.org. These materials may discuss therapeutic products that have not been approved by the US Food and Drug Administration and off-label uses of approved products. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or employing any therapies described in this educational activity.

References

Faculty and Disclosures

Moderator

Scott D. Solomon, MD

Panelists

Philip B. Adamson, MD

Paul Hauptman, MD

Editor

Ronald K. Miller, PhD

Acute MI Steering Committee

Deepak L. Bhatt, MD, MPH

Roberta C. Bogaev, MD

Ted E. Feldman, MD

Jagmeet P. Singh, MD, PhD

CME Reviewer

Nafeez Zawahir, MD

Nurse Planner

Laurie E. Scudder, DNP, NP

CME / CE

Addressing the Risk for Sudden Cardiac Death in Heart Failure

Target Audience and Goal Statement

Disclosures

Moderator

Scott D. Solomon, MD

Panelists

Philip B. Adamson, MD

Paul Hauptman, MD

Editor

Ronald K. Miller, PhD

Acute MI Steering Committee

Deepak L. Bhatt, MD, MPH

Roberta C. Bogaev, MD

Ted E. Feldman, MD

Jagmeet P. Singh, MD, PhD

CME Reviewer

Nafeez Zawahir, MD

Nurse Planner

Laurie E. Scudder, DNP, NP

Accreditation Statements

For Physicians

For Nurses

Instructions for Participation and Credit

Addressing the Risk for Sudden Cardiac Death in Heart Failure