In patients with heart failure (HF) and implanted cardiac defibrillators, ventricular arrhythmias and device therapies remain clinically relevant outcomes when evaluating medical treatment strategies. In Journal of Arrhythmia, a systematic review and meta-analysis assessed the association between sacubitril/valsartan use and arrhythmic outcomes in HF patients with implanted cardiac defibrillators (ICDs). The analysis pooled data from four paired observational cohort studies, comprising a total of 397 patients.

Treatment with sacubitril/valsartan was associated with a significantly lower incidence of ICD shocks, with an odds ratio (OR) of 0.33 (95% confidence interval [CI], 0.19–0.60; p = 0.0003). Appropriate ICD shocks were also reduced (OR, 0.21; 95% CI, 0.10–0.47; p = 0.0001). The analysis showed a reduction in non-sustained ventricular tachycardia (NSVT) duration and lower odds of biventricular pacing below 90%. However, no significant associations were observed for overall ventricular arrhythmia, sustained ventricular tachycardia, NSVT incidence, inappropriate ICD shocks, premature ventricular contractions per hour, or left ventricular ejection fraction.

These findings indicate an association between sacubitril/valsartan use and selected reductions in ICD-related outcomes among HF patients with defibrillators.