Early Electrophysiology Study to Guide Implantable Cardioverter-Defibrillator Use for Preventing Dangerous Heart Rhythms After Heart Attack PROTECT-ICD

What this Trial Is About

Researchers are evaluating ways to prevent sudden cardiac death in patients with poor heart function after a heart attack myocardial infarct. The trial compares the use of an electrophysiology study EPS to guide early implantable cardioverter-defibrillator ICD implantation within 40 days after a heart attack, against standard care. The study also examines whether cardiac MRI CMR can predict dangerous heart rhythms and assess heart tissue damage early after a heart attack. Participants are randomly assigned to one of two groups. In the intervention group, all patients receive an early EPS those with certain types of inducible heart rhythms receive an ICD implant, while others do not. The control group receives standard care, which may include ICD implantation after 40 or 90 days if indicated by current guidelines. Some patients in both groups will have a CMR scan more than 48 hours after revascularization to study heart function, scarring, and tissue health. Participants will be followed for 2 years to monitor for sudden cardiac death or non-fatal heart rhythm problems, which is the main outcome. Other outcomes include overall survival, heart failure, repeat heart attacks, and issues related to ICD use. The study collects detailed heart rhythm and imaging data to better understand risks and improve treatment decisions for patients after a heart attack.

Programmed Ventricular Stimulation to Risk Stratify for Early Cardioverter-Defibrillator (ICD) Implantation to Prevent Tachyarrhythmias Following Acute Myocardial Infarction (PROTECT-ICD)