{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T03:01:58Z","timestamp":1761102118039},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2014,12]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Prophylactic defibrillator implantation is recommended in dilated, nonischemic heart disease and left ventricular ejection fraction of \u22640.30 to 0.35. Noninvasive testing should improve accuracy in decision making of prophylactic defibrillator implantation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              We enrolled 60 patients (median age, 57 years) with dilated cardiomyopathy and left ventricular ejection fraction \u22640.50, and 30 control subjects (median age, 59 years) with left ventricular ejection fraction &gt;0.50. The protocol included an initial assessment, a second assessment after 3 years, and a final follow-up: pharmacological baroreflex testing (baroreceptor reflex sensitivity), short-term spectral analysis of heart rate variability (low frequency\/high frequency), and long-term time domain analysis (SD of all normal-to-normal R\u2013R intervals), exercise microvolt T wave alternans, and signal-averaged ECG, and corrected QT-time. The median follow-up was 7 years. End points were cardiac death, resuscitated cardiac arrest, and arrhythmic death. Cardiac death was observed in 21 patients. Resuscitated cardiac arrest and arrhythmic death caused by ventricular tachyarrhythmias \u2265240 per minute was observed in 7 and 10 patients, respectively. In the single time point analysis, microvolt T wave alternans, baroreceptor reflex sensitivity, and SD of all normal-to-normal R\u2013R intervals at initial testing added significant information regarding cardiac death. Microvolt T wave alternans added information on resuscitated cardiac arrest or arrhythmic death at multiple time points (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). False-negative microvolt T wave alternans results were seen in 8% of patients.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Noninvasive testing and left ventricular ejection fraction could not reliably identify patients with dilated cardiomyopathy at risk of fatal ventricular tachyarrhythmias. Therefore, the strategy to confine prophylactic implantable cardioverter-defibrillator implantation to patients with dilated cardiomyopathy and severely reduced LV function should be reconsidered.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.114.001745","type":"journal-article","created":{"date-parts":[[2014,9,28]],"date-time":"2014-09-28T00:41:32Z","timestamp":1411864892000},"page":"1101-1108","update-policy":"http:\/\/dx.doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Multiple Autonomic and Repolarization Investigation of Sudden Cardiac Death in Dilated Cardiomyopathy and Controls"],"prefix":"10.1161","volume":"7","author":[{"given":"Thomas","family":"Pezawas","sequence":"first","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (T.P., B.R., H.S.); Departments of Medicine (A.D.), and Departments of Medicine, Pharmacology, Neurology (D.R.), Division of Clinical Pharmacology, Vanderbilt Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, TN; Health and Prevention Center, Sanatorium Hera, Vienna, Austria (R.W.); and Department of Biostatistics, Vanderbilt University School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9","family":"Diedrich","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (T.P., B.R., H.S.); Departments of Medicine (A.D.), and Departments of Medicine, Pharmacology, Neurology (D.R.), Division of Clinical Pharmacology, Vanderbilt Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, TN; Health and Prevention Center, Sanatorium Hera, Vienna, Austria (R.W.); and Department of Biostatistics, Vanderbilt University School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Winker","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (T.P., B.R., H.S.); Departments of Medicine (A.D.), and Departments of Medicine, Pharmacology, Neurology (D.R.), Division of Clinical Pharmacology, Vanderbilt Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, TN; Health and Prevention Center, Sanatorium Hera, Vienna, Austria (R.W.); and Department of Biostatistics, Vanderbilt University School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Robertson","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (T.P., B.R., H.S.); Departments of Medicine (A.D.), and Departments of Medicine, Pharmacology, Neurology (D.R.), Division of Clinical Pharmacology, Vanderbilt Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, TN; Health and Prevention Center, Sanatorium Hera, Vienna, Austria (R.W.); and Department of Biostatistics, Vanderbilt University School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernhard","family":"Richter","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (T.P., B.R., H.S.); Departments of Medicine (A.D.), and Departments of Medicine, Pharmacology, Neurology (D.R.), Division of Clinical Pharmacology, Vanderbilt Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, TN; Health and Prevention Center, Sanatorium Hera, Vienna, Austria (R.W.); and Department of Biostatistics, Vanderbilt University School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Wang","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (T.P., B.R., H.S.); Departments of Medicine (A.D.), and Departments of Medicine, Pharmacology, Neurology (D.R.), Division of Clinical Pharmacology, Vanderbilt Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, TN; Health and Prevention Center, Sanatorium Hera, Vienna, Austria (R.W.); and Department of Biostatistics, Vanderbilt University School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel W.","family":"Byrne","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (T.P., B.R., H.S.); Departments of Medicine (A.D.), and Departments of Medicine, Pharmacology, Neurology (D.R.), Division of Clinical Pharmacology, Vanderbilt Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, TN; Health and Prevention Center, Sanatorium Hera, Vienna, Austria (R.W.); and Department of Biostatistics, Vanderbilt University School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Herwig","family":"Schmidinger","sequence":"additional","affiliation":[{"name":"From the Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria (T.P., B.R., H.S.); Departments of Medicine (A.D.), and Departments of Medicine, Pharmacology, Neurology (D.R.), Division of Clinical Pharmacology, Vanderbilt Autonomic Dysfunction Center, Vanderbilt University School of Medicine, Nashville, TN; Health and Prevention Center, Sanatorium Hera, Vienna, Austria (R.W.); and Department of Biostatistics, Vanderbilt University School of..."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199412083312307"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000012350.99718.ad"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa033088"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2007.02.036"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000100721.52503.85"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(84)90522-8"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/tri.12436"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(03)00297-3"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00021-2"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/heart.83.5.531"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02609-X"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(03)00467-4"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2005.00033.x"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.09.004"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.83.4.1481"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2002.00502.x"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-4825(98)00005-5"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)11144-8"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.eurheartj.a014868"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.65.3.457"},{"key":"e_1_3_3_22_2","first-page":"I2","article-title":"Sudden cardiac death. 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