A comparison of antiarrhythmic drug therapy with implantable defibrillators in
patients resuscitated from nearfatal ventricular arrhythmias. The Antiarrhythmics versus
Implantable Defibrillators (AVID) Investigators
New England Journal of Medicine. 1997 Nov 27;337:157683: Issue: 22
Patients who survive life threatening ventricular arrhythmias are at risk for recurrent
arrhythmias. They can be treated with either an implantable
cardioverterdefibrillator or antiarrhythmic drugs - One group of
patients was treated with implantation of a cardioverterdefibrillator; the other
received class III antiarrhythmic drugs, primarily Amiodarone at empirically determined
doses. Of 1016 patients (45 percent of whom had ventricular fibrillation,
and 55 percent ventricular tachycardia), 507 were randomly assigned to treatment with
implantable cardioverterdefibrillators and 509 to antiarrhythmic drug therapy. The
primary end point was overall mortality. Overall survival was greater with
the implantable defibrillator, with unadjusted estimates of 89.3 percent, as compared with
82.3 percent in the antiarrhythmicdrug group at one year, 81.6 percent versus 74.7
percent at two years, and 75.4 percent versus 64.1 percent at three years (P<0.02).
