{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T16:46:45Z","timestamp":1791737205846,"version":"4.3.4"},"reference-count":8,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"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"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Consensus\u2010recommended follow\u2010up after cardiac implantable electronic device (CIED) implantation improves outcomes, yet whether it mediates cardiovascular disparities between device types remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We prospectively studied 6806 patients undergoing CIED implantation across a multi\u2010hospital system (2019\u20132023; median follow\u2010up 3.5 years), categorized as implantable cardioverter defibrillator (ICD) (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092757) or permanent pacemaker (PPM) (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094049). Causal mediation analysis decomposed the effect of device type on major adverse cardiovascular events (MACE) and device extraction into direct and follow\u2010up mediated components, adjusting for demographics and comorbidities.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      ICD recipients had significantly lower consensus\u2010recommended follow\u2010up rates than PPM recipients (65.3% vs. 79.2%; adjusted OR 0.46, 95% CI 0.40\u20130.52,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and substantially higher MACE risk (HR 1.89, 95% CI 1.66\u20132.25,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), of which 53.5% was mediated by follow\u2010up adherence. Device extraction rates were lower in ICD recipients (HR 0.30, 95% CI 0.24\u20130.38), with only 7.9% mediated by follow\u2010up adherence.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>More than half of the excess cardiovascular risk in ICD recipients was statistically mediated by suboptimal follow\u2010up adherence\u2014a potentially modifiable pathway. These findings identify follow\u2010up adherence as a potentially important pathway and support further prospective investigation of strategies to improve monitoring and clinical outcomes in high\u2010risk CIED populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jce.70521","type":"journal-article","created":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T13:36:15Z","timestamp":1791293775000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Consensus\u2010Recommended Follow\u2010Up Mediates Cardiovascular Outcomes Disparities Between Implantable Cardioverter Defibrillator and Pacemaker Recipients"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8583-7381","authenticated-orcid":false,"given":"Jingwen","family":"Huang","sequence":"first","affiliation":[{"name":"Section of Cardiac Electrophysiology, Department of Medicine Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul","family":"Patel","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Department of Medicine Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8918-7224","authenticated-orcid":false,"given":"Chang","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Emory University Rollins School of Public Health Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0708-9330","authenticated-orcid":false,"given":"Michael S.","family":"Lloyd","sequence":"additional","affiliation":[{"name":"Section of Cardiac Electrophysiology, Department of Medicine Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2013.06.009"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/joa3.70203"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2023.03.1525"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000001643"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3389\/feduc.2022.886722"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hroo.2023.11.002"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2012.08.040"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.626"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70521","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jce.70521","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jce.70521","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T16:14:23Z","timestamp":1791735263000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jce.70521"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,6]]},"references-count":8,"alternative-id":["10.1111\/jce.70521"],"URL":"https:\/\/doi.org\/10.1111\/jce.70521","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,6]]},"assertion":[{"value":"2026-04-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jce.70521"}}