{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T14:01:42Z","timestamp":1787320902236,"version":"build-2736575974"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2022,3,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Identification of patients with nonischemic cardiomyopathy who may benefit from prophylactic implantation of a cardioverter-defibrillator. We hypothesized that periodic repolarization dynamics (PRD), a marker of repolarization instability associated with sympathetic activity, could be used to identify patients who will benefit from prophylactic implantable cardioverter defibrillator (ICD) implantation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      We performed a post hoc analysis of DANISH (Danish ICD Study in Patients With Dilated Cardiomyopathy), in which patients with nonischemic cardiomyopathy, left ventricular ejection fraction (LVEF) \u226435%, and elevated NT-proBNP (N-terminal probrain natriuretic peptides) were randomized to ICD implantation or control group. Patients were included in the PRD substudy if they had a 24-hour Holter monitor recording at baseline with technically acceptable ECG signals during the night hours (00:00\u201306:00). PRD was assessed using wavelet analysis according to previously validated methods. The primary end point was all-cause mortality. Cox regression models were adjusted for age, sex, NT-proBNP, estimated glomerular filtration rate, LVEF, atrial fibrillation, ventricular pacing, diabetes, cardiac resynchronization therapy, and mean heart rate. We proposed PRD \u226510 deg\n                      <jats:sup>2<\/jats:sup>\n                      as an exploratory cut-off value for ICD implantation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      A total of 748 of the 1116 patients in DANISH qualified for the PRD substudy. During a mean follow-up period of 5.1\u00b12.0 years, 82 of 385 patients died in the ICD group and 85 of 363 patients died in the control group (\n                      <jats:italic>P<\/jats:italic>\n                      =0.40). In Cox regression analysis, PRD was independently associated with mortality (hazard ratio [HR], 1.28 [95% CI, 1.09\u20131.50] per SD increase;\n                      <jats:italic>P<\/jats:italic>\n                      =0.003). PRD was significantly associated with mortality in the control group (HR, 1.51 [95% CI, 1.25\u20131.81];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) but not in the ICD group (HR, 1.04 [95% CI, 0.83\u20131.54];\n                      <jats:italic>P<\/jats:italic>\n                      =0.71). There was a significant interaction between PRD and the effect of ICD implantation on mortality (\n                      <jats:italic>P<\/jats:italic>\n                      =0.008), with patients with higher PRD having greater benefit in terms of mortality reduction. ICD implantation was associated with an absolute mortality reduction of 17.5% in the 280 patients with PRD \u226510 deg\n                      <jats:sup>2<\/jats:sup>\n                      (HR, 0.54 [95% CI, 0.34\u20130.84];\n                      <jats:italic>P<\/jats:italic>\n                      =0.006; number needed to treat=6), but not in the 468 patients with PRD &lt;10 deg\n                      <jats:sup>2<\/jats:sup>\n                      (HR, 1.17 [95% CI, 0.77\u20131.78];\n                      <jats:italic>P<\/jats:italic>\n                      =0.46;\n                      <jats:italic>P<\/jats:italic>\n                      for interaction=0.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Increased PRD identified patients with nonischemic cardiomyopathy in whom prophylactic ICD implantation led to significant mortality reduction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.121.056464","type":"journal-article","created":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T10:12:07Z","timestamp":1639131127000},"page":"754-764","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Periodic Repolarization Dynamics Identifies ICD Responders in Nonischemic Cardiomyopathy: A DANISH Substudy"],"prefix":"10.1161","volume":"145","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7201-9542","authenticated-orcid":true,"given":"Rune","family":"Boas","sequence":"first","affiliation":[{"name":"Department of Cardiology, Amager Hvidovre University Hospital, University of Copenhagen, Denmark (R.B., U.D.)."},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (R.B., U.D., J.J.T., S.P., L.K., N.E.B., J.H.S.)."},{"name":"Department of Cardiology, Zealand University Hospital Roskilde, Denmark (R.B., N.E.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolay","family":"Sappler","sequence":"additional","affiliation":[{"name":"University Hospital for Internal Medicine III, Medical University of Innsbruck, Austria (N.S., L.v.S., A. Bauer)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2238-2815","authenticated-orcid":true,"given":"Lukas","family":"von St\u00fclpnagel","sequence":"additional","affiliation":[{"name":"University Hospital for Internal Medicine III, Medical University of Innsbruck, Austria (N.S., L.v.S., A. Bauer)."},{"name":"Medizinische Klinik und Poliklinik I, LMU Klinikum, Ludwig-Maximilians-University Munich, Germany (L.v.S., M.K., K.D.R.)., German Centre for Cardiovascular Research (DZHK), Germany (L.v.S., M.K., K.D.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Klemm","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, LMU Klinikum, Ludwig-Maximilians-University Munich, Germany (L.v.S., M.K., K.D.R.)., German Centre for Cardiovascular Research (DZHK), Germany (L.v.S., M.K., K.D.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrik","family":"Dixen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Amager Hvidovre University Hospital, University of Copenhagen, Denmark (R.B., U.D.)."},{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (R.B., U.D., J.J.T., S.P., L.K., N.E.B., J.H.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3621-3775","authenticated-orcid":true,"given":"Jens Jakob","family":"Thune","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (R.B., U.D., J.J.T., S.P., L.K., N.E.B., J.H.S.)."},{"name":"Department of Cardiology, Bispebjerg Frederiksberg University Hospital (J.J.T.), University of Copenhagen, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steen","family":"Pehrson","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (R.B., U.D., J.J.T., S.P., L.K., N.E.B., J.H.S.)."},{"name":"Department of Cardiology, Rigshospitalet, Copenhagen, Denmark (S.P., L.K., B.T.P., J.H.S., J.T.-H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6635-1466","authenticated-orcid":true,"given":"Lars","family":"K\u00f8ber","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (R.B., U.D., J.J.T., S.P., L.K., N.E.B., J.H.S.)."},{"name":"Department of Cardiology, Rigshospitalet, Copenhagen, Denmark (S.P., L.K., B.T.P., J.H.S., J.T.-H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9414-1653","authenticated-orcid":true,"given":"Jens C.","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Departments of Cardiology (J.C.N., H.E.), Aarhus University, Denmark."},{"name":"Clinical Medicine (J.C.N.), Aarhus University, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars","family":"Videb\u00e6k","sequence":"additional","affiliation":[{"name":"Department of Medicine, Odense University Hospital, Svendborg, Denmark (L.V.)."},{"name":"Department of Cardiology, Odense University Hospital, Denmark (L.V., A. Brandes)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Haarbo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Herlev Gentofte University Hospital, Copenhagen, Denmark (J.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Korup","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aalborg University Hospital, Denmark (E.K., A.M.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niels Eske","family":"Bruun","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (R.B., U.D., J.J.T., S.P., L.K., N.E.B., J.H.S.)."},{"name":"Department of Cardiology, Zealand University Hospital Roskilde, Denmark (R.B., N.E.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9145-6887","authenticated-orcid":true,"given":"Axel","family":"Brandes","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Odense University Hospital, Denmark (L.V., A. Brandes)."},{"name":"Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense (A. Brandes)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1520-1924","authenticated-orcid":true,"given":"Hans","family":"Eiskj\u00e6r","sequence":"additional","affiliation":[{"name":"Departments of Cardiology (J.C.N., H.E.), Aarhus University, Denmark."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna M.","family":"Th\u00f8gersen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aalborg University Hospital, Denmark (E.K., A.M.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9479-7601","authenticated-orcid":true,"given":"Berit T.","family":"Philbert","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Rigshospitalet, Copenhagen, Denmark (S.P., L.K., B.T.P., J.H.S., J.T.-H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8466-8515","authenticated-orcid":true,"given":"Jesper Hastrup","family":"Svendsen","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (R.B., U.D., J.J.T., S.P., L.K., N.E.B., J.H.S.)."},{"name":"Department of Cardiology, Rigshospitalet, Copenhagen, Denmark (S.P., L.K., B.T.P., J.H.S., J.T.-H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3895-9316","authenticated-orcid":true,"given":"Jacob","family":"Tfelt-Hansen","sequence":"additional","affiliation":[{"name":"Department of Forensic Medicine, Faculty of Medical Sciences (J.T.-H.), University of Copenhagen, Denmark."},{"name":"Department of Cardiology, Rigshospitalet, Copenhagen, Denmark (S.P., L.K., B.T.P., J.H.S., J.T.-H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9201-8555","authenticated-orcid":true,"given":"Axel","family":"Bauer","sequence":"additional","affiliation":[{"name":"University Hospital for Internal Medicine III, Medical University of Innsbruck, Austria (N.S., L.v.S., A. Bauer)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos D.","family":"Rizas","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik I, LMU Klinikum, Ludwig-Maximilians-University Munich, Germany (L.v.S., M.K., K.D.R.)., German Centre for Cardiovascular Research (DZHK), Germany (L.v.S., M.K., K.D.R.)."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab368"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31829e8807"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199612263352601"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199912163412503"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013474"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043399"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000012350.99718.ad"},{"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":"10.1056\/NEJMoa033088"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1608029"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI70085"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2019.02.024"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx161"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31996-8"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa226"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2016.06.016"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.eurheartj.a014868"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68735-7"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmpb.2010.01.001"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/pan\/mpi014"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/014662168300700301"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/86.11.829"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI26381"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.95.6.1441"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.84.2.482"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000100721.52503.85"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.1363"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.048477"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeu182"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2019-315942"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2016.09.017"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2019.10.020"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.09.073"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCULATIONAHA.121.056464","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T03:54:35Z","timestamp":1715572475000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCULATIONAHA.121.056464"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,8]]},"references-count":33,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2022,3,8]]}},"alternative-id":["10.1161\/CIRCULATIONAHA.121.056464"],"URL":"https:\/\/doi.org\/10.1161\/circulationaha.121.056464","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,8]]},"assertion":[{"value":"2021-07-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-11-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-12-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}