MADIT-ICD Benefit Score

Predicted Benefit of an Implantable Cardioverter-Defibrillator for primary prevention


Current guidelines provide a Class I recommendation for primary implantation of an ICD in patients with left ventricular ejection fraction (LVEF) ≤ 35%. However, the benefit of the ICD for primary prevention is not uniform due to differences in the risk of ventricular tachyarrhythmia (VT or VF) and non-arrhythmic mortality in patients with a low LVEF. Accordingly, we are presenting a prediction model that integrates the risk of VT/VF with the risk of non-arrhythmic mortality in all 4531 patients with an ICD enrolled in the landmark MADIT trials (MADIT-II, MADIT-RISK, MADIT-CRT, and MADIT-RIT). We believe that our proposed MADIT-ICD Benefit Score can be used for shared decision-making in ICD candidates with a low LVEF.


Younis A, Goldberger JJ, Kutyifa V, Zareba W, Polonsky B, Klein H, Aktas MK, Huang D, Daubert J, Estes M, Cannom D, McNitt S, Stein K, Goldenberg I.

Eur Heart J. 2021;42(17):1676-1684. doi: 10.1093/eurheartj/ehaa1057. PMID: 33417692

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1. LVEF ≤ 25%?

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