{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T21:52:18Z","timestamp":1791841938505,"version":"4.3.4"},"reference-count":54,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,9,15]],"date-time":"2023-09-15T00:00:00Z","timestamp":1694736000000},"content-version":"vor","delay-in-days":44,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"DEEP RISK ICD","award":["452019308"],"award-info":[{"award-number":["452019308"]}]},{"name":"F.V.Y.T."},{"name":"Rubicon"},{"DOI":"10.13039\/501100003246","name":"Dutch Research Council","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003246","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100019741","name":"Amsterdam Cardiovascular Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019741","id-type":"DOI","asserted-by":"publisher"}]},{"name":"F.V.Y.T"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Left ventricular ejection fraction (LVEF) is suboptimal as a sole marker for predicting sudden cardiac death (SCD). Machine learning (ML) provides new opportunities for personalized predictions using complex, multimodal data. This study aimed to determine if risk stratification for implantable cardioverter-defibrillator (ICD) implantation can be improved by ML models that combine clinical variables with 12-lead electrocardiograms (ECG) time-series features.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>A multicentre study of 1010 patients (64.9 \u00b1 10.8 years, 26.8% female) with ischaemic, dilated, or non-ischaemic cardiomyopathy, and LVEF \u2264 35% implanted with an ICD between 2007 and 2021 for primary prevention of SCD in two academic hospitals was performed. For each patient, a raw 12-lead, 10-s ECG was obtained within 90 days before ICD implantation, and clinical details were collected. Supervised ML models were trained and validated on a development cohort (n = 550) from Hospital A to predict ICD non-arrhythmic mortality at three-year follow-up (i.e. mortality without prior appropriate ICD-therapy). Model performance was evaluated on an external patient cohort from Hospital B (n = 460). At three-year follow-up, 16.0% of patients had died, with 72.8% meeting criteria for non-arrhythmic mortality. Extreme gradient boosting models identified patients with non-arrhythmic mortality with an area under the receiver operating characteristic curve (AUROC) of 0.90 [95% confidence intervals (CI) 0.80\u20131.00] during internal validation. In the external cohort, the AUROC was 0.79 (95% CI 0.75\u20130.84).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>ML models combining ECG time-series features and clinical variables were able to predict non-arrhythmic mortality within three years after device implantation in a primary prevention population, with robust performance in an independent cohort.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/europace\/euad271","type":"journal-article","created":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T18:50:46Z","timestamp":1694717446000},"source":"Crossref","is-referenced-by-count":29,"title":["Optimizing patient selection for primary prevention implantable cardioverter-defibrillator implantation: utilizing multimodal machine learning to assess risk of implantable cardioverter-defibrillator non-benefit"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0624-1510","authenticated-orcid":false,"given":"Maarten Z H","family":"Kolk","sequence":"first","affiliation":[{"name":"Department of Cardiology, Heart Center, Amsterdam UMC location University of Amsterdam , Meibergdreef 9, 1105 AZ Amsterdam , The Netherlands"},{"name":"Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias , Meibergdreef 9, 1105 AZ Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5425-4175","authenticated-orcid":false,"given":"Samuel","family":"Ruip\u00e9rez-Campillo","sequence":"additional","affiliation":[{"name":"Department of Medicine and Cardiovascular Institute, Stanford University , 780 Welch Road, MC 5773, Stanford, CA 94305 , USA"},{"name":"Department of Information Technology and Electrical Engineering, Swiss Federal Institute of Technology Zurich (ETHz) , Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8800-0002","authenticated-orcid":false,"given":"Brototo","family":"Deb","sequence":"additional","affiliation":[{"name":"Department of Medicine and Cardiovascular Institute, Stanford University , 780 Welch Road, MC 5773, Stanford, CA 94305 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4418-2160","authenticated-orcid":false,"given":"Erik J","family":"Bekkers","sequence":"additional","affiliation":[{"name":"Faculty of Science, University of Amsterdam , Science Park 904, 1098 XH Amsterdam , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelis P","family":"Allaart","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam UMC location Vrije Universiteit Amsterdam , De Boelelaan 1117, 1081 HV Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6585-534X","authenticated-orcid":false,"given":"Albert J","family":"Rogers","sequence":"additional","affiliation":[{"name":"Department of Medicine and Cardiovascular Institute, Stanford University , 780 Welch Road, MC 5773, Stanford, CA 94305 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2791-9124","authenticated-orcid":false,"given":"Anne-Lotte C J","family":"Van Der Lingen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amsterdam UMC location Vrije Universiteit Amsterdam , De Boelelaan 1117, 1081 HV Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4814-1374","authenticated-orcid":false,"given":"Laura","family":"Alvarez Florez","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center, Amsterdam UMC location University of Amsterdam , Meibergdreef 9, 1105 AZ Amsterdam , The Netherlands"},{"name":"Amsterdam Cardiovascular Sciences, Heart Failure and Arrhythmias , Meibergdreef 9, 1105 AZ Amsterdam , The Netherlands"},{"name":"Department of Biomedical Engineering and Physics, Amsterdam UMC location University of Amsterdam , Meibergdreef 9, 1105 AZ Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1869-5034","authenticated-orcid":false,"given":"Ivana","family":"Isgum","sequence":"additional","affiliation":[{"name":"Faculty of Science, University of Amsterdam , Science Park 904, 1098 XH Amsterdam , the Netherlands"},{"name":"Department of Biomedical Engineering and Physics, Amsterdam UMC location University of Amsterdam , Meibergdreef 9, 1105 AZ Amsterdam , The Netherlands"},{"name":"Department of Radiology and Nuclear Medicine, Amsterdam UMC location University of Amsterdam , Meibergdreef 9, 1105 AZ Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8358-6849","authenticated-orcid":false,"given":"Bob D","family":"De Vos","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering and Physics, Amsterdam UMC location University of Amsterdam , Meibergdreef 9, 1105 AZ Amsterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0642-0861","authenticated-orcid":false,"given":"Paul","family":"Clopton","sequence":"additional","affiliation":[{"name":"Department of Medicine and Cardiovascular Institute, Stanford University , 780 Welch Road, MC 5773, Stanford, CA 94305 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0528-0852","authenticated-orcid":false,"given":"Arthur A M","family":"Wilde","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center, Amsterdam 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