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Correspondence
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Volume 338:1227-1228 April 23, 1998 Number 17
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Prophylactic Use of Implanted Cardiac Defibrillators in Patients at High Risk for Ventricular Arrhythmias after Coronary-Artery Bypass Graft Surgery

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by Moss, A. J.
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by Bigger, J. T.
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To the Editor: In their well-conducted trial, Bigger et al. (Nov. 27 issue)1 found no evidence of improved survival among patients with a depressed left ventricular ejection fraction and an abnormal signal-averaged electrocardiogram in whom a defibrillator had been implanted prophylactically at the time of coronary-artery bypass graft (CABG) surgery. The authors offer several explanations for their observation, including the possible beneficial effect of coronary bypass surgery on the autonomic nervous input to the heart.

It has become increasingly clear that the autonomic nervous system is important in the pathogenesis of ventricular arrhythmias and sudden death from cardiac causes. Heightened . . . [Full Text of this Article]

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