ICDs were studied for their effect on mortality in 228 consecutive heart transplant candidates on the transplant waiting list. 207 patients did not have an ICD and 21 did have an ICD.
	The mortality rate in 207 patients without ICD was 23% and in 21 patients with ICD was 5%. In a model for all 228 study patients (mortality while on the waiting list was 22%; transplant rate: 55%), the absence of an ICD was a barely significant predictor of death risk.
	However, the absence of an ICD was a powerful predictor of mortality for a sub-group of 134 patients with high-grade ventricular arrhythmias as shown by Holter monitor and for a sub-group of 58 survivors of sudden cardiac death. ICD therapy is strongly recommended in transplant candidates with a history of sudden cardiac death. General preventive use of ICDs in heart transplant candidates cannot be justified.

Title: The impact of implantable cardioverter-defibrillators on mortality among patients on the waiting list for heart transplantation
Authors: Grimm M, Wieselthaler G, Avanessian R, Grimm G, Schmidinger H, Schreiner W, Podczeck A, Wolner E, Laufer G - Department of Cardiothoracic Surgery, University of Vienna, Austria
From: J Thorac Cardiovasc Surg 1995 Aug;110(2):532-9
PMID: 7637372, UI: 95364393