{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T07:13:20Z","timestamp":1773558800952,"version":"3.50.1"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,8,17]],"date-time":"2020-08-17T00:00:00Z","timestamp":1597622400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Noninvasive risk stratification aims to detect abnormalities in the pathophysiological mechanisms underlying ventricular arrhythmias. We studied the predictive value of repeating risk stratification in patients with an implantable cardioverter\u2010defibrillator (ICD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The EUTrigTreat clinical study was a prospective multicenter trial including ischemic and nonischemic cardiomyopathies and arrhythmogenic heart disease. Left ventricular ejection fraction \u226440% (LVEF), premature ventricular complexes &gt;400\/24\u00a0hr (PVC), non\u2010negative microvolt T\u2010wave alternans (MTWA), and abnormal heart rate turbulence (HRT) were considered high risk. Tests were repeated within 12\u00a0months after inclusion. Adjusted Cox regression analysis was performed for mortality and appropriate ICD shocks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 635 patients had analyzable baseline data with a median follow\u2010up of 4.4\u00a0years. Worsening of LVEF was associated with increased mortality (HR 3.59, 95% CI 1.17\u201311.04), as was consistent abnormal HRT (HR 8.34, 95%CI 1.06\u201365.54). HRT improvement was associated with improved survival when compared to consistent abnormal HRT (HR 0.10, 95%CI 0.01\u20130.82). For appropriate ICD shocks, a non\u2010negative MTWA test or high PVC count at any moment was associated with increased arrhythmic risk independent of the evolution of test results (worsening: HR 3.76 (95%CI 1.43\u20139.88) and HR 2.50 (95%CI 1.15\u20135.46); improvement: HR 2.80 (95%CI 1.03\u20137.61) and HR 2.45 (95%CI 1.07\u20135.62); consistent: HR 2.47 (95%CI 0.95\u20136.45) and HR 2.40 (95%CI 1.33\u20134.33), respectively). LVEF improvement was associated with a lower arrhythmic risk (HR 0.34, 95%CI 0.12\u20130.94).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Repeating LVEF and HRT improved the prediction of mortality, whereas stratification of ventricular arrhythmias may be improved by repeating LVEF measurements, MTWA and ECG Holter monitoring.<\/jats:p><\/jats:sec>","DOI":"10.1111\/anec.12794","type":"journal-article","created":{"date-parts":[[2020,8,27]],"date-time":"2020-08-27T23:09:25Z","timestamp":1598569765000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Repeating noninvasive risk stratification improves prediction of outcome in ICD patients"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8296-920X","authenticated-orcid":false,"given":"Bert","family":"Vandenberk","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Sciences University 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