Fewer Heart Failure Patients Dying of Cardiac Arrest

Updated: Oct 11, 2021

Heart failure patients are much less likely now to die from sudden cardiac arrest, new research shows.

Rates of sudden death from heart failure have declined by nearly half over the past two decades, according to data gathered from a dozen separate clinical trials.

Better heart medications used in effective combinations are extending the lives of people with heart failure, said senior study author Dr. John McMurray, a professor of cardiology with the University of Glasgow in Scotland.

"Patients with heart failure and reduced ejection fraction certainly are living longer, and I think are also living better," McMurray said. "Modern pharmacological and device therapy is very effective, and we are now fairly commonly seeing patients with substantial or even complete recovery of their heart muscle dysfunction."

In fact, medicines have become so effective that many low-risk heart failure patients may not need to receive an implantable cardioverter-defibrillator (ICD) to protect their lives, McMurray and his international colleagues argued.

"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 said. "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 -- i.e., how to target ICDs to the highest-risk patients."

For this study, researchers analyzed data on more than 40,000 heart failure patients enrolled in 12 clinical trials conducted between 1995 and 2014.

Heart failure occurs when the heart grows too weak to pump enough blood to meet the needs of the body. Most heart failure patients develop reduced ejection fraction, a condition in which the lower chambers of the heart (ventricles) do not squeeze hard enough to pump oxygen-rich blood out to the body.

Patients with reduced ejection fraction often die suddenly from cardiac arrest because their ventricles develop a dangerously erratic heartbeat, the researchers explained in background notes.

To prevent this, many heart failure patients receive an ICD, the researchers said. These devices monitor heart rhythm and deliver an electrical shock to restore normal rhythm if the heartbeat starts to go awry.

But over the past two decades, many new drugs have become available that are effective at helping a struggling heart beat strongly and in an organized fashion, McMurray said.

The combined data from the clinical trials showed that sudden death rates have fallen by 44 percent in heart failure patients who have not received an ICD.