Another Shock for Sudden Death Prevention after Myocardial Infarction

Sudden cardiac death, typically due to a ventricular tachyarrhythmia, is a devastating complication of myocardial infarction that poses the greatest risk during the first 30 days after the infarct, especially among patients with a reduced left ventricular ejection fraction.1 However, two randomized, controlled trials showed no survival benefit with early implantation of an implantable cardioverter–defibrillator (ICD) after myocardial infarction.2,3 Consequently, clinical practice guidelines recommend waiting for at least 40 days after myocardial infarction and 90 days after coronary revascularization for the implantation of an ICD for primary prevention.4 This paradox of increased risk of sudden cardiac death but lack of . . .