Sudden cardiac death of two heart transplant patients with correctly functioning implantable cardioverter defibrillators.

It is unclear whether the usual criteria for implantation of implantable cardioverter defibrillators in patients at risk of sudden death can be generalized to heart transplant recipients. We describe sudden death in 2 heart transplant recipients despite correctly functioning implantable cardioverter defibrillators. The scant relevant literature is reviewed. We conclude that implantable cardioverter defibrillators are unlikely to assist heart transplant recipients with severe coronary allograft vasculopathy and poor ventricular systolic function, the group with the highest incidence of sudden death.