{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T12:06:29Z","timestamp":1753272389929,"version":"3.37.3"},"reference-count":28,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,7,29]],"date-time":"2021-07-29T00:00:00Z","timestamp":1627516800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Factors influencing malignant arrhythmia onset are not fully understood. We explored the circadian periodicity of ventricular arrhythmias (VAs) in patients with implantable cardioverter and cardiac resynchronization defibrillators (ICD\/CRT\u2010D).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Time, morphology (monomorphic\/polymorphic), and mode of termination (anti\u2010tachycardia pacing [ATP] or shock) of VAs stored in a database of remote monitoring data were adjudicated. Episodes were grouped in six 4\u2010h timeslots from 00:00 to 24:00. Circadian distributions and adjusted marginal odds ratios (ORs), with 95% confidence interval (CI), were analyzed using mixed\u2010effect models and logit generalized estimating equations, respectively, to account for within\u2010subject correlation of multiple episodes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 1303 VA episodes from 446 patients (63% ICD and 37% CRT\u2010D), 120 (9%) self\u2010extinguished, and 842 (65%) were terminated by ATP, 343 (26%) by shock. VAs clustered from 08:00 to 16:00 with 44% of episodes, as compared with 22% from 00:00 to 08:00 (<jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and 34% from 16:00 to 24:00 (<jats:italic>p<\/jats:italic>\u2009=\u2009.005). Episodes were more likely to be polymorphic at night with an adjusted marginal OR of 1.66 (CI, 1.15\u20132.40; <jats:italic>p<\/jats:italic>\u2009=\u2009.007) at 00:00\u201304:00 versus other timeslots. Episodes were less likely to be terminated by ATP in the 00:00\u201304:00 (success\u2010to\u2010failure ratio, 0.67; CI, 0.46\u20130.98; <jats:italic>p<\/jats:italic>\u2009=\u2009.039) and 08:00\u201312:00 (0.70; CI, 0.51\u20130.96; <jats:italic>p<\/jats:italic>\u2009=\u2009.02) timeslots, and most likely to be terminated by ATP between 12:00 and 16:00 (success\u2010to\u2010failure ratio 1.42; CI, 1.06\u20131.91; <jats:italic>p<\/jats:italic>\u2009=\u2009.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>VAs did not distribute uniformly over the 24\u2009h, with a majority of episodes occurring from 08:00 to 16:00. Nocturnal episodes were more likely to be polymorphic. The efficacy of ATP depended on the time of delivery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15154","type":"journal-article","created":{"date-parts":[[2021,7,12]],"date-time":"2021-07-12T23:50:16Z","timestamp":1626133816000},"page":"2528-2535","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Circadian periodicity affects the type of ventricular arrhythmias and efficacy of implantable defibrillator therapies"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7751-6871","authenticated-orcid":false,"given":"Pasquale","family":"Vergara","sequence":"first","affiliation":[{"name":"Arrhythmia Unit and Electrophysiology Laboratory IRCCS San Raffaele Scientific Institute Milano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Pignalberi","sequence":"additional","affiliation":[{"name":"Ospedale San Filippo Neri Roma Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ennio C.","family":"Pisan\u00f2","sequence":"additional","affiliation":[{"name":"Ospedale Vito Fazzi Lecce Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giampiero","family":"Maglia","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliera Pugliese Ciaccio Catanzaro Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8346-1387","authenticated-orcid":false,"given":"Paolo","family":"Della Bella","sequence":"additional","affiliation":[{"name":"Arrhythmia Unit and Electrophysiology Laboratory IRCCS San Raffaele Scientific Institute Milano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriele","family":"Zanotto","sequence":"additional","affiliation":[{"name":"Ospedale Mater Salutis Legnago Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2131-1110","authenticated-orcid":false,"given":"Saverio","family":"Iacopino","sequence":"additional","affiliation":[{"name":"Villa Maria Care &amp; Research Cotignola Ravenna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Solimene","sequence":"additional","affiliation":[{"name":"Clinica Montevergine Mercogliano Avellino Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeria","family":"Calvi","sequence":"additional","affiliation":[{"name":"Policlinico G. 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