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  1. Article ; Online: Left-Sided Humerus Fracture as an Unusual Complication of Defibrillation Threshold Testing Following S-ICD Implantation.

    Elders, Jan / AlHashimi, Hisham

    JACC. Case reports

    2020  Volume 2, Issue 2, Page(s) 255–257

    Abstract: Comminuted subcapital humerus fracture as a complication of subcutaneous implantable cardioverter-defibrillator insertion is related to an abducted and externally rotated arm position during the defibrillation threshold test at which the current pathway ... ...

    Abstract Comminuted subcapital humerus fracture as a complication of subcutaneous implantable cardioverter-defibrillator insertion is related to an abducted and externally rotated arm position during the defibrillation threshold test at which the current pathway is through the pectoral muscle. It is advisable to adduct the arm before defibrillation threshold testing. (
    Language English
    Publishing date 2020-01-29
    Publishing country Netherlands
    Document type Case Reports
    ISSN 2666-0849
    ISSN (online) 2666-0849
    DOI 10.1016/j.jaccas.2019.08.031
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Subcutaneous ICD implantation under ultrasound-guided serratus anterior plane block: Single-center experience in the Netherlands.

    Elders, Jan / AlHashimi, Hisham / Gomes, Marc / Panhuizen, Ivo / van Kuijk, Sander / Vernooy, Kevin

    International journal of cardiology. Heart & vasculature

    2022  Volume 38, Page(s) 100949

    Abstract: Introduction: To avoid general anesthesia (GA) and improve postoperative pain management for subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation there is a growing interest for alternative methods. We describe the first experience ... ...

    Abstract Introduction: To avoid general anesthesia (GA) and improve postoperative pain management for subcutaneous implantable cardioverter-defibrillator (S-ICD) implantation there is a growing interest for alternative methods. We describe the first experience in the Netherlands of S-ICD implantation under Ultrasound-guided Serratus Anterior Plane Block (US-SAPB).
    Methods: US-SAPB was performed 1 hour before S-ICD implantation. The two-incision technique was used and a pocket beneath the latissimus dorsi muscle was surgically created. Lidocaine was used to provide anesthesia of the skin. Sedation during defibrillation testing (DFT) was induced by intravenous Propofol. Periprocedural pain experience was monitored using the Numerical Rating Scale for Pain (NRS-Pain). The results were compared with a control group of patients undergoing S-ICD implantation under GA.
    Results: Forty consecutive patients (29 Male/11 Female, median age 59 years (range 34-84 years), median body mass index 26 (range 17-41) underwent S-ICD implantation; Twenty patients under US-SAPB and twenty under GA. Median procedure time was 42 min. (range 28-60 min.) with no differences between both groups. In both groups implantations went successful and defibrillation was accomplished using 65 J. US-SAPB was successful in 19 of the 20 patients and GA was successful in all cases. Median NRS-Pain in the US-SAPB group was 2 (range 2-6) and in the GA group 4 (range 2-6). In the US-SAPB group 5 patients required additional opioids postoperatively compared to 10 patients in the GA group.
    Conclusions: S-ICD implantation under US-SAPB is feasible, safe and reduces the need for postoperative opioids significantly. S-ICD implantation under US-SAPB seems a good alternative for GA.
    Language English
    Publishing date 2022-01-05
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 2818464-6
    ISSN 2352-9067
    ISSN 2352-9067
    DOI 10.1016/j.ijcha.2021.100949
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  3. Article ; Online: Previous Exercise Levels and Outcome in Patients with New Atrial Fibrillation: 'Past Achievements Do Not Predict the Future'.

    Lenting, Charlotte J / Wijtvliet, E P J Petra / Koldenhof, Tim / Bessem, Bram / Pluymaekers, Nikki A H A / Rienstra, Michiel / Folkeringa, Richard J / Bronzwaer, Patrick / Elvan, Arif / Elders, Jan / Tukkie, Raymond / Luermans, Justin G L M / Van Kuijk, Sander M J / Tijssen, Jan G P / Van Gelder, Isabelle C / Crijns, Harry J G M / Tieleman, Robert G

    Medicine and science in sports and exercise

    2024  

    Abstract: Introduction: Long-term endurance exercise is suspect to elevate the risk of atrial fibrillation (AF),but little is known about cardiovascular outcome and disease progression in this subgroup of AF patients. We investigated whether previous exercise ... ...

    Abstract Introduction: Long-term endurance exercise is suspect to elevate the risk of atrial fibrillation (AF),but little is known about cardiovascular outcome and disease progression in this subgroup of AF patients. We investigated whether previous exercise level determines cardiovascular outcome.
    Methods: In this post hoc analysis of the RACE 4 randomized trial, we analyzed all patients with a completed questionnaire on sports participation. Three subgroups were made based on lifetime sports hours up to randomization and previous compliance to the international physical activity guidelines. High lifetime hours of high dynamic activity patients were defined as more than 150 min/week of high intense physical exercise. The primary endpoint was a composite of cardiovascular death and hospital admissions.
    Results: A total of 879 patients were analyzed, divided in 203 high lifetime hours of high dynamic activity -, 192 high lifetime hours of activity- and 484 low lifetime hours of activity patients. Over a mean follow up of 36 months (±14), the primary endpoint occurred in 61 out of 203 (30%) high lifetime hours of high dynamic activity -, 53 out of 192 (27%) high lifetime hours of activity- and 135 out of 484 low lifetime hours of activity patients (28%) (p = 0.74). During follow up 42 high lifetime hours of high dynamic activity- (35%), 43 high lifetime hours of activity- (32%) and 104 low lifetime hours of activity patients (34%) with paroxysmal AF received electrical or chemical cardioversion or atrial ablation (p = 0.90).
    Conclusions: In patients included in the RACE 4, there appears to be no relation between previous activity levels and cardiovascular outcome and the need for electrical or chemical cardioversion or atrial ablation. Cardiovascular outcome was driven by AF related arrhythmic events.
    Language English
    Publishing date 2024-04-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 603994-7
    ISSN 1530-0315 ; 0195-9131 ; 0025-7990
    ISSN (online) 1530-0315
    ISSN 0195-9131 ; 0025-7990
    DOI 10.1249/MSS.0000000000003424
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  4. Article ; Online: Rate control drugs differ in the prevention of progression of atrial fibrillation.

    Koldenhof, Tim / Wijtvliet, Petra E P J / Pluymaekers, Nikki A H A / Rienstra, Michiel / Folkeringa, Richard J / Bronzwaer, Patrick / Elvan, Arif / Elders, Jan / Tukkie, Raymond / Luermans, Justin G L M / van Kuijk, Sander M J / Tijssen, Jan G P / van Gelder, Isabelle C / Crijns, Harry J G M / Tieleman, Robert G

    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

    2021  Volume 24, Issue 3, Page(s) 384–389

    Abstract: Aims: We hypothesize that in patients with paroxysmal atrial fibrillation (AF), verapamil is associated with lower AF progression compared to beta blockers or no rate control.: Methods and results: In this pre-specified post hoc analysis of the RACE ... ...

    Abstract Aims: We hypothesize that in patients with paroxysmal atrial fibrillation (AF), verapamil is associated with lower AF progression compared to beta blockers or no rate control.
    Methods and results: In this pre-specified post hoc analysis of the RACE 4 randomized trial, the effect of rate control medication on AF progression in paroxysmal AF was analysed. Patients using Vaughan-Williams Class I or III antiarrhythmic drugs were excluded. The primary outcome was a composite of first electrical cardioversion (ECV), chemical cardioversion (CCV), or atrial ablation. Event rates are displayed using Kaplan-Meier curves and multivariable Cox regression analyses are used to adjust for baseline differences. Out of 666 patients with paroxysmal AF, 47 used verapamil, 383 used beta blockers, and 236 did not use rate control drugs. The verapamil group was significantly younger than the beta blocker group and contained more men than the no rate control group. Over a mean follow-up of 37 months, the primary outcome occurred in 17% in the verapamil group, 33% in the beta blocker group, and 33% in the no rate control group (P = 0.038). After adjusting for baseline characteristics, patients using verapamil have a significantly lower chance of receiving ECV, CCV, or atrial ablation compared to patients using beta blockers [hazard ratio (HR) 0.40, 95% confidence interval (CI) 0.19-0.83] and no rate control (HR 0.64, 95% CI 0.44-0.93).
    Conclusion: In patients with newly diagnosed paroxysmal AF, verapamil was associated with less AF progression, as compared to beta blockers and no rate control.
    MeSH term(s) Anti-Arrhythmia Agents/therapeutic use ; Atrial Fibrillation/diagnosis ; Atrial Fibrillation/drug therapy ; Atrial Fibrillation/epidemiology ; Catheter Ablation/adverse effects ; Electric Countershock/adverse effects ; Electric Countershock/methods ; Humans ; Male ; Treatment Outcome
    Chemical Substances Anti-Arrhythmia Agents
    Language English
    Publishing date 2021-08-19
    Publishing country England
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/euab191
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  5. Article ; Online: Predictive value of the PRAETORIAN score for defibrillation test success in patients with subcutaneous ICD: A subanalysis of the PRAETORIAN-DFT trial.

    Knops, Reinoud E / El-Chami, Mikhael F / Marquie, Christelle / Nordbeck, Peter / Quast, Anne-Floor B E / Tilz, Roland R / Brouwer, Tom F / Lambiase, Pier D / Cassidy, Christopher J / Boersma, Lucas V A / Burke, Martin C / Pepplinkhuizen, Shari / de Veld, Jolien A / de Weger, Anouk / Bracke, Frank A L E / Manyam, Harish / Probst, Vincent / Betts, Timothy R / Bijsterveld, Nick R /
    Defaye, Pascal / Demming, Thomas / Elders, Jan / Field, Duncan C / Ghani, Abdul / Golovchiner, Gregory / de Jong, Jonas S S G / Lewis, Nigel / Marijon, Eloi / Martin, Claire A / Miller, Marc A / Shaik, Naushad A / van der Stuijt, Willeke / Kuschyk, Jürgen / Olde Nordkamp, Louise R A / Arya, Anita / Borger van der Burg, Alida E / Boveda, Serge / van Doorn, Dirk J / Glikson, Michael / Kaiser, Lukas / Maass, Alexander H / van Woerkens, Léon J P M / Zaidi, Amir / Wilde, Arthur A M / Smeding, Lonneke

    Heart rhythm

    2024  

    Abstract: Background: The PRAETORIAN score estimates the risk of failure of subcutaneous implantable cardioverter-defibrillator (S-ICD) therapy by using generator and lead positioning on bidirectional chest radiographs. The PRospective randomized compArative ... ...

    Abstract Background: The PRAETORIAN score estimates the risk of failure of subcutaneous implantable cardioverter-defibrillator (S-ICD) therapy by using generator and lead positioning on bidirectional chest radiographs. The PRospective randomized compArative trial of subcutanEous implanTable cardiOverter-defibrillatoR ImplANtation with and without DeFibrillation Testing (PRAETORIAN-DFT) investigates whether PRAETORIAN score calculation is noninferior to defibrillation testing (DFT) with regard to first shock efficacy in spontaneous events.
    Objective: This prespecified subanalysis assessed the predictive value of the PRAETORIAN score for defibrillation success in induced ventricular arrhythmias.
    Methods: This multicenter investigator-initiated trial randomized 965 patients between DFT and PRAETORIAN score calculation after de novo S-ICD implantation. Successful DFT was defined as conversion of induced ventricular arrhythmia in <5 seconds from shock delivery within 2 attempts. Bidirectional chest radiographs were obtained after implantation. The predictive value of the PRAETORIAN score for DFT success was calculated for patients in the DFT arm.
    Results: In total, 482 patients were randomized to undergo DFT. Of these patients, 457 (95%) underwent DFT according to protocol, of whom 445 (97%) had successful DFT and 12 (3%) had failed DFT. A PRAETORIAN score of ≥90 had a positive predictive value of 25% for failed DFT, and a PRAETORIAN score of <90 had a negative predictive value of 99% for successful DFT. A PRAETORIAN score of ≥90 was the strongest independent predictor for failed DFT (odds ratio 33.77; confidence interval 6.13-279.95; P < .001).
    Conclusion: A PRAETORIAN score of <90 serves as a reliable indicator for DFT success in patients with S-ICD, and a PRAETORIAN score of ≥90 is a strong predictor for DFT failure.
    Language English
    Publishing date 2024-02-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2229357-7
    ISSN 1556-3871 ; 1547-5271
    ISSN (online) 1556-3871
    ISSN 1547-5271
    DOI 10.1016/j.hrthm.2024.02.005
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  6. Article ; Online: High incidence of implantable cardioverter defibrillator malfunctions during radiation therapy: neutrons as a probable cause of soft errors.

    Elders, Jan / Kunze-Busch, Martina / Jan Smeenk, Robert / Smeets, Joep L R M

    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

    2013  Volume 15, Issue 1, Page(s) 60–65

    Abstract: Aims: To investigate the behaviour of the implantable cardioverter defibrillator (ICD) function during actual radiotherapy sessions.: Methods and results: Fifteen patients with an ICD underwent 17 radiation treatments for cancer [cumulative dose to ... ...

    Abstract Aims: To investigate the behaviour of the implantable cardioverter defibrillator (ICD) function during actual radiotherapy sessions.
    Methods and results: Fifteen patients with an ICD underwent 17 radiation treatments for cancer [cumulative dose to the tumour was between 16 Gray (Gy) and 70 Gy; photon beams with maximum energies between 6 megaelectronvolt (MeV) and 18 MeV were employed]. During every session, the ICD was programmed to a monitoring mode to prevent inappropriate therapy delivery. Afterwards, the ICDs were interrogated to ensure proper function. Calculated radiation dose at the ICD site was <1 Gy in all patients. In 5 out of 17 radiation treatments (29%) the ICDs showed 6 malfunctions (35%). We noticed four disturbances in the memory data or device resets during radiation treatment and one case of inappropriate ventricular fibrillation detection due to external noise. In one case a late device data error was observed. All malfunctions occurred at 10 and 18 MeV beam energies.
    Conclusion: Despite the fact that all recommended precautions were taken to minimize the damage to the ICDs during radiotherapy and the calculated dose to the ICDs was <1 Gy, in 29% of the treatments a malfunction occurred. We observed a possible correlation between the beam energy and the malfunctions. This correlation may be due to an interaction between neutrons produced in the head of the linear accelerator at beam energies ≥10 MeV, and boron-10 which is present in the integrated circuit.
    MeSH term(s) Aged ; Defibrillators, Implantable/statistics & numerical data ; Equipment Failure/statistics & numerical data ; Equipment Failure Analysis/statistics & numerical data ; Female ; Heart Failure/epidemiology ; Heart Failure/prevention & control ; Humans ; Incidence ; Male ; Middle Aged ; Netherlands ; Neutrons ; Radiation Dosage ; Radiotherapy, Conformal/statistics & numerical data ; Risk Factors
    Language English
    Publishing date 2013-01
    Publishing country England
    Document type Journal Article
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/eus197
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  7. Article ; Online: The application of cardiac computed tomography to visualize the coronary vein anatomy for implantation of cardiac resynchronization therapy in a patient with a cardiac right-lateral displacement and rotation.

    Elders, Jan / Winkens, Mark H M / Zegers, Erwin S / Bouwels, Leon H R

    European heart journal cardiovascular Imaging

    2012  Volume 13, Issue 2, Page(s) 200

    MeSH term(s) Atrial Fibrillation/etiology ; Atrial Fibrillation/therapy ; Cardiac Resynchronization Therapy/methods ; Coronary Vessels/anatomy & histology ; Defibrillators, Implantable ; Female ; Heart/diagnostic imaging ; Heart Ventricles/diagnostic imaging ; Humans ; Middle Aged ; Pneumonectomy/adverse effects ; Risk Factors ; Rotation ; Tachycardia, Ventricular/etiology ; Tachycardia, Ventricular/therapy ; Tomography, X-Ray Computed/methods ; Treatment Outcome
    Language English
    Publishing date 2012-02
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2638345-7
    ISSN 2047-2412 ; 2047-2404
    ISSN (online) 2047-2412
    ISSN 2047-2404
    DOI 10.1093/ejechocard/jer264
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  8. Article ; Online: Nurse-led vs. usual-care for atrial fibrillation.

    Wijtvliet, E P J Petra / Tieleman, Robert G / van Gelder, Isabelle C / Pluymaekers, Nikki A H A / Rienstra, Michiel / Folkeringa, Richard J / Bronzwaer, Patrick / Elvan, Arif / Elders, Jan / Tukkie, Raymond / Luermans, Justin G L M / Van Asselt, A D I Thea / Van Kuijk, Sander M J / Tijssen, Jan G / Crijns, Harry J G M

    European heart journal

    2019  Volume 41, Issue 5, Page(s) 634–641

    Abstract: Background: Nurse-led integrated care is expected to improve outcome of patients with atrial fibrillation compared with usual-care provided by a medical specialist.: Methods and results: We randomized 1375 patients with atrial fibrillation (64 ± 10 ... ...

    Abstract Background: Nurse-led integrated care is expected to improve outcome of patients with atrial fibrillation compared with usual-care provided by a medical specialist.
    Methods and results: We randomized 1375 patients with atrial fibrillation (64 ± 10 years, 44% women, 57% had CHA2DS2-VASc ≥ 2) to receive nurse-led care or usual-care. Nurse-led care was provided by specialized nurses using a decision-support tool, in consultation with the cardiologist. The primary endpoint was a composite of cardiovascular death and cardiovascular hospital admissions. Of 671 nurse-led care patients, 543 (81%) received anticoagulation in full accordance with the guidelines against 559 of 683 (82%) usual-care patients. The cumulative adherence to guidelines-based recommendations was 61% under nurse-led care and 26% under usual-care. Over 37 months of follow-up, the primary endpoint occurred in 164 of 671 patients (9.7% per year) under nurse-led care and in 192 of 683 patients (11.6% per year) under usual-care [hazard ratio (HR) 0.85, 95% confidence interval (CI) 0.69 to 1.04, P = 0.12]. There were 124 vs. 161 hospitalizations for arrhythmia events (7.0% and 9.4% per year), and 14 vs. 22 for heart failure (0.7% and 1.1% per year), respectively. Results were not consistent in a pre-specified subgroup analysis by centre experience, with a HR of 0.52 (95% CI 0.37-to 0.71) in four experienced centres and of 1.24 (95% CI 0.94-1.63) in four less experienced centres (P for interaction <0.001).
    Conclusion: Our trial failed to show that nurse-led care was superior to usual-care. The data suggest that nurse-led care by an experienced team could be clinically beneficial (ClinicalTrials.gov NCT01740037).
    Trial registration number: ClinicalTrials.gov (NCT01740037).
    MeSH term(s) Aged ; Anticoagulants/therapeutic use ; Atrial Fibrillation/therapy ; Female ; Heart Failure ; Hospitalization ; Humans ; Male ; Middle Aged ; Nurse's Role ; Proportional Hazards Models ; Stroke
    Chemical Substances Anticoagulants
    Language English
    Publishing date 2019-09-22
    Publishing country England
    Document type Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 603098-1
    ISSN 1522-9645 ; 0195-668X
    ISSN (online) 1522-9645
    ISSN 0195-668X
    DOI 10.1093/eurheartj/ehz666
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  9. Article: Implantation of a biventricular pacing system in a patient with a coronary sinus not communicating with the right atrium.

    van Gelder, Berry M / Elders, Jan / Bracke, Frank A / Meijer, Albert

    Pacing and clinical electrophysiology : PACE

    2003  Volume 26, Issue 5, Page(s) 1294–1296

    Abstract: Intubation of the coronary sinus failed during implantation of a biventricular pacing system. An angiogram of the left coronary artery showed in the venous phase a coronary sinus not communicating with the right atrium. The coronary sinus was draining ... ...

    Abstract Intubation of the coronary sinus failed during implantation of a biventricular pacing system. An angiogram of the left coronary artery showed in the venous phase a coronary sinus not communicating with the right atrium. The coronary sinus was draining into a persistent left superior vena cava communicating with the left subclavian vein. The coronary sinus lead was successfully implanted through the persistent left superior vena cava, whereas the atrial and ventricular leads were implanted through the right superior vena cava in a conventional way.
    MeSH term(s) Aged ; Coronary Angiography ; Female ; Heart Atria/abnormalities ; Heart Failure/surgery ; Heart Septal Defects/diagnostic imaging ; Humans ; Myocardial Ischemia/surgery ; Pacemaker, Artificial ; Vena Cava, Superior/abnormalities
    Language English
    Publishing date 2003-05-16
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 424437-0
    ISSN 1540-8159 ; 0147-8389
    ISSN (online) 1540-8159
    ISSN 0147-8389
    DOI 10.1046/j.1460-9592.2003.t01-1-00184.x
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  10. Article ; Online: Development and external validation of prediction models to predict implantable cardioverter-defibrillator efficacy in primary prevention of sudden cardiac death.

    Verstraelen, Tom E / van Barreveld, Marit / van Dessel, Pascal H F M / Boersma, Lucas V A / Delnoy, Peter-Paul P H M / Tuinenburg, Anton E / Theuns, Dominic A M J / van der Voort, Pepijn H / Kimman, Gerardus P / Buskens, Erik / Hulleman, Michiel / Allaart, Cornelis P / Strikwerda, Sipke / Scholten, Marcoen F / Meine, Mathias / Abels, René / Maass, Alexander H / Firouzi, Mehran / Widdershoven, Jos W M G /
    Elders, Jan / van Gent, Marco W F / Khan, Muchtiar / Vernooy, Kevin / Grauss, Robert W / Tukkie, Raymond / van Erven, Lieselot / Spierenburg, Han A M / Brouwer, Marc A / Bartels, Gerard L / Bijsterveld, Nick R / Borger van der Burg, Alida E / Vet, Mattheus W / Derksen, Richard / Knops, Reinoud E / Bracke, Frank A L E / Harden, Markus / Sticherling, Christian / Willems, Rik / Friede, Tim / Zabel, Markus / Dijkgraaf, Marcel G W / Zwinderman, Aeilko H / Wilde, Arthur A M

    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

    2021  Volume 23, Issue 6, Page(s) 887–897

    Abstract: Aims: This study was performed to develop and externally validate prediction models for appropriate implantable cardioverter-defibrillator (ICD) shock and mortality to identify subgroups with insufficient benefit from ICD implantation.: Methods and ... ...

    Abstract Aims: This study was performed to develop and externally validate prediction models for appropriate implantable cardioverter-defibrillator (ICD) shock and mortality to identify subgroups with insufficient benefit from ICD implantation.
    Methods and results: We recruited patients scheduled for primary prevention ICD implantation and reduced left ventricular function. Bootstrapping-based Cox proportional hazards and Fine and Gray competing risk models with likely candidate predictors were developed for all-cause mortality and appropriate ICD shock, respectively. Between 2014 and 2018, we included 1441 consecutive patients in the development and 1450 patients in the validation cohort. During a median follow-up of 2.4 (IQR 2.1-2.8) years, 109 (7.6%) patients received appropriate ICD shock and 193 (13.4%) died in the development cohort. During a median follow-up of 2.7 (IQR 2.0-3.4) years, 105 (7.2%) received appropriate ICD shock and 223 (15.4%) died in the validation cohort. Selected predictors of appropriate ICD shock were gender, NSVT, ACE/ARB use, atrial fibrillation history, Aldosterone-antagonist use, Digoxin use, eGFR, (N)OAC use, and peripheral vascular disease. Selected predictors of all-cause mortality were age, diuretic use, sodium, NT-pro-BNP, and ACE/ARB use. C-statistic was 0.61 and 0.60 at respectively internal and external validation for appropriate ICD shock and 0.74 at both internal and external validation for mortality.
    Conclusion: Although this cohort study was specifically designed to develop prediction models, risk stratification still remains challenging and no large group with insufficient benefit of ICD implantation was found. However, the prediction models have some clinical utility as we present several scenarios where ICD implantation might be postponed.
    MeSH term(s) Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Cohort Studies ; Death, Sudden, Cardiac/prevention & control ; Defibrillators, Implantable ; Humans ; Primary Prevention ; Risk Factors
    Chemical Substances Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors
    Language English
    Publishing date 2021-02-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 1449879-0
    ISSN 1532-2092 ; 1099-5129
    ISSN (online) 1532-2092
    ISSN 1099-5129
    DOI 10.1093/europace/euab012
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