{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T11:25:57Z","timestamp":1740137157737,"version":"3.37.3"},"reference-count":37,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T00:00:00Z","timestamp":1625788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004374","name":"Medtronic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004374","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>In primary prevention (PP) patients the utilization of implantable cardioverter\u2010defibrillators (ICD) and cardiac resynchronization therapy\u2010defibrillators (CRT\u2010D) remains low in many geographies, despite the proven mortality benefit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The objective of this analysis was to examine the mortality benefit in PP patients by guideline\u2010indicated device type: ICD\u00a0and CRT\u2010D.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Improve sudden cardiac arrest was a prospective, nonrandomized, nonblinded multicenter trial that enrolled patients from regions where ICD utilization is low. PP patient's CRT\u2010D or ICD eligibility was based upon the 2008 ACC\/AHA\/HRS and 2006 ESC guidelines. Mortality was assessed according to guideline\u2010indicated device type comparing implanted and nonimplanted patients. Cox proportional hazards methods were used, adjusting for known factors affecting mortality risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 2618 PP patients followed for a mean of 20.8\u2009\u00b1\u200910.8 months, 1073 were indicated for a CRT\u2010D, and 1545 were indicated for an ICD. PP CRT\u2010D\u2010indicated patients who received CRT\u2010D therapy had a 58% risk reduction in mortality compared with those without implant (adjusted hazard ratio [HR]: 0.42, 95% confidence interval [CI]: 0.28\u20130.61, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001). PP patients with an ICD indication had a 43% risk reduction in mortality with an ICD implant compared with no implant (adjusted HR: 0.57, 95% CI: 0.41\u20130.81, <jats:italic>p<\/jats:italic>\u2009=\u2009.002).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This analysis confirms the mortality benefit of adherence to guideline\u2010indicated implantable defibrillation therapy for PP patients in geographies where ICD therapy was underutilized. These results affirm that medical practice should follow clinical guidelines when choosing therapy for PP patients who meet the respective defibrillator device implant indication.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15149","type":"journal-article","created":{"date-parts":[[2021,7,3]],"date-time":"2021-07-03T07:26:26Z","timestamp":1625297186000},"page":"2285-2294","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The mortality analysis of primary prevention patients receiving a cardiac resynchronization defibrillator (CRT\u2010D) or implantable cardioverter\u2010defibrillator (ICD) according to guideline indications in the improve SCA study"],"prefix":"10.1111","volume":"32","author":[{"given":"Chi Keong","family":"Ching","sequence":"first","affiliation":[{"name":"Department of Cardiology National Heart Centre of Singapore  Outram 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Instituto de Cardiolog\u00eda Fundaci\u00f3n Cardio infantil Centro Internacional de Arritmias  Bogot\u00e1 Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young\u2010Hoon","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of\u00a0Cardiology Korea University Anam Hospital  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9036-7225","authenticated-orcid":false,"given":"Boyoung","family":"Joung","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Severance Hospital Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Balbir","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Cardiology Medanta, The Medicity Hospital  Gurgaon Haryana 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