{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:54:30Z","timestamp":1781589270881,"version":"3.54.5"},"reference-count":4,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T00:00:00Z","timestamp":1772928000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T00:00:00Z","timestamp":1772928000000},"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":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Unsuccessful defibrillation therapy in patients with implantable cardiac defibrillators (ICDs) and ventricular tachytherapies may occur due to patient and\/or device\u2010related factors; appropriate management strategies after failed defibrillation therapy have been incompletely described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To report on the management and outcomes of patients with implantable cardiac devices and unsuccessful defibrillation therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single\u2010center cohort of patients with ICDs was examined, patients with unsuccessful ICD therapies were included. Demographic and device features, and survival free from recurrent unsuccessful device therapy was examined among patients undergoing operative vs. non\u2010operative management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1449 patients with ICDs, 40 patients (2.8%) were identified with unsuccessful defibrillation therapies (mean age 59\u2009\u00b1\u200915 years, ejection fraction 29%\u2009\u00b1\u200916%, ischemic cardiomyopathy\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200927, 67.5%, secondary prevention device placement\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200922, 55%, transvenous ICD\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200934, 85%, subcutaneous ICD\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096, 15%). Nonoperative management strategies included device reprogramming (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098), addition of a class III anti\u2010arrhythmic (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097), or conservative therapy (\n                      <jats:italic>n\u2009<\/jats:italic>\n                      =\u20095). Operative management included addition of a transvenous lead (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910), addition of subcutaneous array (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098), or change in pulse generator (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092). A single\u2010coil device was present in 18\/20(90%) patients undergoing operative management compared to 10\/20 (50%) with non\u2010operative management (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.16). There were no demographic or device differences between the two groups. After 2.4\u2009\u00b1\u20092.1 years follow up, repeat VT occurred in 22 patients (55%) including 6 patients (15%) with a repeat failed defibrillator therapy. There was no differences in the risk of recurrent failed shocks among patients with operative vs non\u2010operative management (log rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.14).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among a large cohort of patients with ICD, the incidence of failed defibrillator therapy was 2.8%. With appropriate patient selection, both operative and non\u2010operative management led to similar long\u2010term outcomes; however, the overall incidence of repeat failed defibrillation therapy remained high at 15%.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70310","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:24:37Z","timestamp":1773030277000},"page":"1356-1358","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patients Experiencing Unsuccessful Defibrillation From Implantable Cardiac Devices Remain at Elevated Risk Despite Procedural Management"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6222-9415","authenticated-orcid":false,"given":"Nathaniel","family":"Christian\u2010Miller","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Electrophysiology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muazzum","family":"Shah","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Electrophysiology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7880-9745","authenticated-orcid":false,"given":"Kelly","family":"Arps","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Electrophysiology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2733-2844","authenticated-orcid":false,"given":"Amrish","family":"Deshmukh","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Electrophysiology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackson","family":"Liang","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Electrophysiology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Cunnane","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Electrophysiology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krit","family":"Jongnarangsin","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Electrophysiology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Pelosi","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Electrophysiology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hakan","family":"Oral","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Electrophysiology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6951-5238","authenticated-orcid":false,"given":"Michael","family":"Ghannam","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Electrophysiology University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,8]]},"reference":[{"key":"e_1_2_3_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000549"},{"key":"e_1_2_3_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2007.00730.x"},{"key":"e_1_2_3_4_1","doi-asserted-by":"publisher","DOI":"10.4330\/wjc.v5.i4.106"},{"key":"e_1_2_3_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61903-6"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70310","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.70310","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70310","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:42:32Z","timestamp":1781588552000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.70310"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,8]]},"references-count":4,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/jce.70310"],"URL":"https:\/\/doi.org\/10.1111\/jce.70310","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,8]]},"assertion":[{"value":"2025-10-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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