{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T09:52:51Z","timestamp":1791971571637,"version":"4.3.4"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In heart failure with reduced ejection fraction (HFrEF), a substantial proportion of deaths are arrhythmic. Implantable cardioverter\u2010defibrillators (ICDs) are recommended for primary prevention in patients with left ventricular ejection fraction (LVEF) \u2264\u200935% despite guideline\u2010directed medical therapy (GDMT), but landmark trials predate widespread use of angiotensin receptor\u2013neprilysin inhibitors (ARNI) and sodium\u2013glucose cotransporter 2 inhibitors (SGLT2i), raising uncertainty about arrhythmic risk in the contemporary treatment era.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively studied consecutive HFrEF patients undergoing primary\u2010prevention ICD implantation at a single center (2015\u20132022), categorized into historical\u2010era and contemporary\u2010era cohorts by ARNI\/SGLT2i adoption. Propensity\u2010score matching balanced baseline characteristics. The primary endpoint was time to first appropriate ICD therapy (antitachycardia pacing or shock).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 289 patients (mean age 62\u2009\u00b1\u200911\u2009years, 82% male), 234 (117 per group) remained after matching. Mean follow\u2010up was 51\u2009months. Appropriate ICD therapy incidence did not differ significantly between contemporary\u2010era and historical\u2010era cohorts (hazard ratio [HR] 1.52, 95% CI 0.84\u20132.72;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.165). Competing\u2010risk\u2010adjusted cumulative incidence was numerically higher in the contemporary\u2010era cohort at a pre\u2010specified 36\u2010months horizon, consistent with a sensitivity analysis using an expanded propensity\u2010score model (HR 1.55, 95% CI 0.82\u20132.94).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ICD therapy rates were not significantly different between the contemporary\u2010era and historical\u2010era cohorts, a finding robust to sensitivity and competing\u2010risk analyses. These results should be interpreted cautiously, as the study may be underpowered to detect modest differences, and clinically relevant effects cannot be excluded.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/joa3.70497","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T06:42:07Z","timestamp":1791528127000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Appropriate\n                    <scp>ICD<\/scp>\n                    Therapies in Primary Prevention: A Propensity\u2010Matched Comparison of Contemporary and Historic Heart Failure Cohorts"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7076-4724","authenticated-orcid":false,"given":"In\u00eas","family":"Ferreira Neves","sequence":"first","affiliation":[{"name":"Hospital de Santa Marta Unidade Local de Sa\u00fade S. Jos\u00e9, Centro Hospitalar Universit\u00e1rio de Lisboa Central  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2590-1274","authenticated-orcid":false,"given":"Guilherme","family":"Portugal","sequence":"additional","affiliation":[{"name":"Hospital de Santa Marta Unidade Local de Sa\u00fade S. Jos\u00e9, Centro Hospitalar Universit\u00e1rio de Lisboa Central  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Lopes","sequence":"additional","affiliation":[{"name":"Hospital de Santa Marta Unidade Local de Sa\u00fade S. Jos\u00e9, Centro Hospitalar Universit\u00e1rio de Lisboa Central  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Rita","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Hospital de Santa Marta Unidade Local de Sa\u00fade S. Jos\u00e9, Centro Hospitalar Universit\u00e1rio de Lisboa Central  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9465-634X","authenticated-orcid":false,"given":"Pedro","family":"Silva Cunha","sequence":"additional","affiliation":[{"name":"Hospital de Santa Marta Unidade Local de Sa\u00fade S. Jos\u00e9, Centro Hospitalar Universit\u00e1rio de Lisboa Central  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Valente","sequence":"additional","affiliation":[{"name":"Hospital de Santa Marta Unidade Local de Sa\u00fade S. Jos\u00e9, Centro Hospitalar Universit\u00e1rio de Lisboa Central  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Lousinha","sequence":"additional","affiliation":[{"name":"Hospital de Santa Marta Unidade Local de Sa\u00fade S. Jos\u00e9, Centro Hospitalar Universit\u00e1rio de Lisboa Central  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1873-0074","authenticated-orcid":false,"given":"Rita","family":"Moreira","sequence":"additional","affiliation":[{"name":"Hospital de Santa Marta Unidade Local de Sa\u00fade S. Jos\u00e9, Centro Hospitalar Universit\u00e1rio de Lisboa Central  Lisboa Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5785-0124","authenticated-orcid":false,"given":"H\u00e9lder","family":"Santos","sequence":"additional","affiliation":[{"name":"Hospital de Santa Marta Unidade Local de Sa\u00fade S. 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