{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T03:50:04Z","timestamp":1776311404751,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T00:00:00Z","timestamp":1727049600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T00:00:00Z","timestamp":1727049600000},"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":["Pacing Clinical Electrophis"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nonischemic cardiomyopathy (NICM) is responsible for approximately one\u2010third of heart failure and is associated with significant morbidity and mortality. Recent data suggested the lack of mortality reduction from adding a defibrillator to cardiac resynchronization therapy (CRT) in all patients with NICM. Myocardial fibrosis detected by cardiac magnetic resonance late gadolinium enhancement (CMR\u2010LGE) can help risk stratify patients who would benefit from adding a defibrillator to CRT in this patient population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aim to assess the relationship between the presence of myocardial fibrosis detected by CMR\u2010LGE and the rate of major arrhythmic events (MAE) that included sustained ventricular tachycardia (VT), appropriate cardiac resynchronization therapy\u2010defibrillator (CRT\u2010D) intervention, ventricular fibrillation (VF), and sudden cardiac death (SCD) in patients with NICM undergoing CRT and to compare all\u2010cause mortality and heart failure improvement between patients receiving cardiac resynchronization therapy\u2010pacing (CRT\u2010P) versus those receiving CRT\u2010D based on the presence of myocardial fibrosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All consecutive patients with NICM satisfying a guideline\u2010directed indication for CRT implantation were included in the study after excluding patients who refused to consent, patients with acute decompensated heart failure, and those contraindicated for a cardiac magnetic resonance (CMR). Patients were divided into two groups based on the presence of fibrosis in cardiac MRI: the LGE\/CRT\u2010D group and the No LGE\/CRT\u2010P group. They\nwere then followed for 1 year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty patients were enrolled. Sixteen patients (26.6%) developed MAE during the study duration, among those patients, seven had myocardial fibrosis (receiving CRT\u2010D as per protocol), while nine had no myocardial fibrosis (receiving CRT\u2010P as per protocol), (41.2%\u00a0vs. 20.9%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.045). The presence of CMR\u2010LGE, regardless of the extent and distribution, predicted MAE with an odds ratio of 2.6 (CI = 1.78\u20138.9,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.04). The presence of \u22657.5% of myocardial fibrosis by CMR was associated with 54% sensitivity and 100% specificity for MAE in the study population. All\u2010cause mortality was significantly higher in the No LGE\/CRT\u2010P group versus the LGE\/CRT\u2010D group (15 [34.9%] vs. 2 [11.8%],\n                      <jats:italic>p<\/jats:italic>\n                      = 0.076).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In patients with NICM candidates for biventricular pacing, the presence of LGE on CMR, irrespective of the extent or segmental pattern, is independently associated with an MAE and is associated with worse heart failure outcomes. However, the absence of LGE did not rule out MAE, and implanting CRT\u2010P based on lack of fibrosis may result in higher all\u2010cause mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pace.15076","type":"journal-article","created":{"date-parts":[[2024,9,23]],"date-time":"2024-09-23T07:12:56Z","timestamp":1727075576000},"page":"1528-1538","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Utility of Cardiac Magnetic Resonance in Assessing Arrhythmic Risk in Patients With Nonischemic Cardiomyopathy Undergoing Biventricular Pacing"],"prefix":"10.1111","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7065-497X","authenticated-orcid":false,"given":"Ahmed","family":"El\u2010Damaty","sequence":"first","affiliation":[{"name":"Department of Cardiology Cairo University  Giza Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Sayed","sequence":"additional","affiliation":[{"name":"Department of Cardiology Aswan Heart Center  Aswan Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"El\u2010Maghawry","sequence":"additional","affiliation":[{"name":"Department of Cardiology El\u2010NAS Hospital  Shubra al Khaymah Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hossam","family":"Kandil","sequence":"additional","affiliation":[{"name":"Department of Cardiology Cairo University  Giza Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Cardiology Cairo University  Giza Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,9,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euab232"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac262"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1608029"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.11.013"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2016.01.033"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2005.10.005"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2008.11.023"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2019.02.034"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1062-1458(02)00961-3"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(03)01042-8"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.20.2685"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacep.2017.02.006"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.07.049"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.05.054"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.02.070"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejheart.2005.11.014"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.10.032"},{"issue":"4","key":"e_1_2_12_19_1","doi-asserted-by":"crossref","first-page":"1877","DOI":"10.1002\/j.2040-4603.2015.tb00658.x","article-title":"Physiological Implications of Myocardial Scar Structure","volume":"5","author":"Richardson W. 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