The Risk Estimation Following Infarction Noninvasive Evaluation - ICD efficacy (REFINE ICD) trial is an international and multi-centered clinical trial.

Sudden death prematurely ends hundreds of thousands of lives each and every year. In North American, over seven million adults are heart attack survivors and they have a four-fold higher risk of sudden death compared to persons without a history of heart attack. In post-heart attack patients, the majority of sudden and abnormal rhythmic deaths occur in those with at least mildly reduced heart pumping function (left ventricular ejection fraction/LVEF below 0.50).

The implantable cardioverter defibrillator (ICD) has revolutionized the treatment of patients at risk for sudden death. However, current risk assessment approaches can not effectively identify the majority of patients at the risk of sudden death. In the REFINE ICD study, we will use simple and non-invasive test results (through 24-hour ECG or Holter test) to identify abnormal electrical signals from the heart that may be associated with fast and dangerous heart rhythm and result in sudden death. This study will evaluate whether ICD therapy increases the survival rate compared to usual care in heart attack patients with reduced heart pumping function (LVEF between 0.36 to 0.50) .


Currently recruiting participants: Yes

Eligible gender: Male, Female, Transgender, Other

Eligible ages: 18 to 80

Inclusion criteria:

Persons had a heart attack and have reduced heart pumping function.


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Principal Investigator: Dr. Katherine Kavanagh; Study Coordinator: Wei Qi, Ph.D.

Principal investigator:

Katherine Kavanagh

Clinical trial: