{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T23:04:57Z","timestamp":1789945497991,"version":"4.0.1"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>The benefit of novel implantable cardioverter defibrillator (ICD) programming in reducing inappropriate ICD therapy and mortality was demonstrated in Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy (MADIT-RIT). However, the cause of mortality reduction remains incompletely evaluated. We aimed to identify factors associated with mortality, with focus on ICD therapy and programming in the MADIT-RIT population.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              In MADIT-RIT, 1500 patients with a primary prophylactic indication for ICD or cardiac resynchronization therapy with defibrillator were randomized to 1 of 3 different ICD programming arms: conventional programming (ventricular tachycardia zone \u2265170 beats per minute), high-rate programming (ventricular tachycardia zone \u2265200 beats per minute), and delayed programming (60-second delay before therapy \u2265170 beats per minute). Multivariate Cox models were used to assess the influence of time-dependent appropriate and inappropriate ICD therapy (shock and antitachycardia pacing) and randomized programming arm on all-cause mortality. During an average follow-up of 1.4\u00b10.6 years, 71 of 1500 (5%) patients died: cardiac in 40 patients (56.3%), noncardiac in 23 patients (32.4%), and unknown in 8 patients (11.3%). Appropriate shocks (hazard ratio, 6.32; 95% confidence interval, 3.13\u201312.75;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and inappropriate therapy (hazard ratio, 2.61; 95% confidence interval, 1.28\u20135.31;\n              <jats:italic>P<\/jats:italic>\n              =0.01) were significantly associated with an increased mortality risk. There was no evidence of increased mortality risk in patients who experienced appropriate antitachycardia pacing only (hazard ratio, 1.02; 95% confidence interval, 0.36\u20132.88;\n              <jats:italic>P<\/jats:italic>\n              =0.98). Randomization to conventional programming was identified as an independent predictor of death when compared with patients randomized to high-rate programming (hazard ratio, 2.0; 95% confidence interval, 1.06\u20133.71;\n              <jats:italic>P<\/jats:italic>\n              =0.03).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>In MADIT-RIT, appropriate shocks, inappropriate ICD therapy, and randomization to conventional ICD programming were independently associated with an increased mortality risk. Appropriate antitachycardia pacing was not related to an adverse outcome.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/clinicaltrials.gov\">clinicaltrials.gov<\/jats:ext-link>\n              Unique identifier: NCT00947310.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.114.001623","type":"journal-article","created":{"date-parts":[[2014,8,19]],"date-time":"2014-08-19T05:05:22Z","timestamp":1408424722000},"page":"785-792","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":114,"title":["Mortality Reduction in Relation to Implantable Cardioverter Defibrillator Programming in the Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy (MADIT-RIT)"],"prefix":"10.1161","volume":"7","author":[{"given":"Anne-Christine","family":"Ruwald","sequence":"first","affiliation":[{"name":"From the Heart Research Follow-up Program, University of Rochester Medical Center, NY (A.-C.R., A.J.M., V.K., M.H.R., D.T.H., H.K., S.M., C.A.B., M.W.B., W.Z.); Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (A.-C.R., M.H.R.); Division of Cardiology, Henry Ford Hospital, Detroit, MI (C.S.); Department of Medicine, University of Iowa Health Care, Iowa City (B.O.); St Luke\u2019s and Roosevelt Hospitals, Departments of Medicine and Epidemiology, Columbia University, New York, NY ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Schuger","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, University of Rochester Medical Center, NY (A.-C.R., A.J.M., V.K., M.H.R., D.T.H., H.K., S.M., C.A.B., M.W.B., W.Z.); Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (A.-C.R., M.H.R.); Division of Cardiology, Henry Ford Hospital, Detroit, MI (C.S.); Department of Medicine, University of Iowa Health Care, Iowa City (B.O.); St Luke\u2019s and Roosevelt Hospitals, Departments of Medicine and Epidemiology, Columbia University, New York, NY ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur J.","family":"Moss","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, University of Rochester Medical Center, NY (A.-C.R., A.J.M., V.K., M.H.R., D.T.H., H.K., S.M., C.A.B., M.W.B., W.Z.); Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (A.-C.R., M.H.R.); Division of Cardiology, Henry Ford Hospital, Detroit, MI (C.S.); Department of Medicine, University of Iowa Health Care, Iowa City (B.O.); St Luke\u2019s and Roosevelt Hospitals, Departments of Medicine and Epidemiology, Columbia University, New York, NY ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Kutyifa","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, University of Rochester Medical Center, NY (A.-C.R., A.J.M., V.K., M.H.R., D.T.H., H.K., S.M., C.A.B., M.W.B., W.Z.); Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (A.-C.R., M.H.R.); Division of Cardiology, Henry Ford Hospital, Detroit, MI (C.S.); Department of Medicine, University of Iowa Health Care, Iowa City (B.O.); St Luke\u2019s and Roosevelt Hospitals, Departments of Medicine and Epidemiology, Columbia University, New York, NY ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Olshansky","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, University of Rochester Medical Center, NY (A.-C.R., A.J.M., V.K., M.H.R., D.T.H., H.K., S.M., C.A.B., M.W.B., W.Z.); Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (A.-C.R., M.H.R.); Division of Cardiology, Henry Ford Hospital, Detroit, MI (C.S.); Department of Medicine, University of Iowa Health Care, Iowa City (B.O.); St Luke\u2019s and Roosevelt Hospitals, Departments of Medicine and Epidemiology, Columbia University, New York, NY ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Greenberg","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, University of Rochester Medical Center, NY (A.-C.R., A.J.M., V.K., M.H.R., D.T.H., H.K., S.M., C.A.B., M.W.B., W.Z.); Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (A.-C.R., M.H.R.); Division of Cardiology, Henry Ford Hospital, Detroit, MI (C.S.); Department of Medicine, University of Iowa Health Care, Iowa City (B.O.); St Luke\u2019s and Roosevelt Hospitals, Departments of Medicine and Epidemiology, Columbia University, New York, NY ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Cannom","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, University of Rochester Medical Center, NY (A.-C.R., A.J.M., V.K., M.H.R., D.T.H., H.K., S.M., C.A.B., M.W.B., W.Z.); Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (A.-C.R., M.H.R.); Division of Cardiology, Henry Ford Hospital, Detroit, MI (C.S.); Department of Medicine, University of Iowa Health Care, Iowa City (B.O.); St Luke\u2019s and Roosevelt Hospitals, Departments of Medicine and Epidemiology, Columbia University, New York, NY ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.A. 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Department of Medicine, University of Iowa Health Care, Iowa City (B.O.); St Luke\u2019s and Roosevelt Hospitals, Departments of Medicine and Epidemiology, Columbia University, New York, NY ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David T.","family":"Huang","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, University of Rochester Medical Center, NY (A.-C.R., A.J.M., V.K., M.H.R., D.T.H., H.K., S.M., C.A.B., M.W.B., W.Z.); Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (A.-C.R., M.H.R.); Division of Cardiology, Henry Ford Hospital, Detroit, MI (C.S.); Department of Medicine, University of Iowa Health Care, Iowa City (B.O.); St Luke\u2019s and Roosevelt Hospitals, Departments of Medicine and Epidemiology, Columbia University, New York, NY ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helmut","family":"Klein","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, University of Rochester Medical Center, NY (A.-C.R., A.J.M., V.K., M.H.R., D.T.H., H.K., S.M., C.A.B., M.W.B., W.Z.); Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (A.-C.R., M.H.R.); Division of Cardiology, Henry Ford Hospital, Detroit, MI (C.S.); Department of Medicine, University of Iowa Health Care, Iowa City (B.O.); St Luke\u2019s and Roosevelt Hospitals, Departments of Medicine and Epidemiology, Columbia University, New York, NY ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"McNitt","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, University of Rochester Medical Center, NY (A.-C.R., A.J.M., V.K., M.H.R., D.T.H., H.K., S.M., C.A.B., M.W.B., W.Z.); Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (A.-C.R., M.H.R.); Division of Cardiology, Henry Ford Hospital, Detroit, MI (C.S.); Department of Medicine, University of Iowa Health Care, Iowa City (B.O.); St Luke\u2019s and Roosevelt Hospitals, Departments of Medicine and Epidemiology, Columbia University, New York, NY ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher A.","family":"Beck","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, University of Rochester Medical Center, NY (A.-C.R., A.J.M., V.K., M.H.R., D.T.H., H.K., S.M., C.A.B., M.W.B., W.Z.); Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (A.-C.R., M.H.R.); Division of Cardiology, Henry Ford Hospital, Detroit, MI (C.S.); Department of Medicine, University of Iowa Health Care, Iowa City (B.O.); St Luke\u2019s and Roosevelt Hospitals, Departments of Medicine and Epidemiology, Columbia University, New York, NY ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Goldstein","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, University of Rochester Medical Center, NY (A.-C.R., A.J.M., V.K., M.H.R., D.T.H., H.K., S.M., C.A.B., M.W.B., W.Z.); Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (A.-C.R., M.H.R.); Division of Cardiology, Henry Ford Hospital, Detroit, MI (C.S.); Department of Medicine, University of Iowa Health Care, Iowa City (B.O.); St Luke\u2019s and Roosevelt Hospitals, Departments of Medicine and Epidemiology, Columbia University, New York, NY ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary W.","family":"Brown","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, University of Rochester Medical Center, NY (A.-C.R., A.J.M., V.K., M.H.R., D.T.H., H.K., S.M., C.A.B., M.W.B., W.Z.); Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (A.-C.R., M.H.R.); Division of Cardiology, Henry Ford Hospital, Detroit, MI (C.S.); Department of Medicine, University of Iowa Health Care, Iowa City (B.O.); St Luke\u2019s and Roosevelt Hospitals, Departments of Medicine and Epidemiology, Columbia University, New York, NY ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josef","family":"Kautzner","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, University of Rochester Medical Center, NY (A.-C.R., A.J.M., V.K., M.H.R., D.T.H., H.K., S.M., C.A.B., M.W.B., W.Z.); Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (A.-C.R., M.H.R.); Division of Cardiology, Henry Ford Hospital, Detroit, MI (C.S.); Department of Medicine, University of Iowa Health Care, Iowa City (B.O.); St Luke\u2019s and Roosevelt Hospitals, Departments of Medicine and Epidemiology, Columbia University, New York, NY ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morio","family":"Shoda","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, University of Rochester Medical Center, NY (A.-C.R., A.J.M., V.K., M.H.R., D.T.H., H.K., S.M., C.A.B., M.W.B., W.Z.); Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (A.-C.R., M.H.R.); Division of Cardiology, Henry Ford Hospital, Detroit, MI (C.S.); Department of Medicine, University of Iowa Health Care, Iowa City (B.O.); St Luke\u2019s and Roosevelt Hospitals, Departments of Medicine and Epidemiology, Columbia University, New York, NY ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Wilber","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, University of Rochester Medical Center, NY (A.-C.R., A.J.M., V.K., M.H.R., D.T.H., H.K., S.M., C.A.B., M.W.B., W.Z.); Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (A.-C.R., M.H.R.); Division of Cardiology, Henry Ford Hospital, Detroit, MI (C.S.); Department of Medicine, University of Iowa Health Care, Iowa City (B.O.); St Luke\u2019s and Roosevelt Hospitals, Departments of Medicine and Epidemiology, Columbia University, New York, NY ..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wojciech","family":"Zareba","sequence":"additional","affiliation":[{"name":"From the Heart Research Follow-up Program, University of Rochester Medical Center, NY (A.-C.R., A.J.M., V.K., M.H.R., D.T.H., H.K., S.M., C.A.B., M.W.B., W.Z.); 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