{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:54:52Z","timestamp":1787018092518,"version":"build-2736575974"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2014,8,15]]},"abstract":"\n Background<\/jats:title>\n \n Randomized studies of implantable cardioverter defibrillators (\n ICD<\/jats:styled-content>\n ) have excluded sudden cardiac death survivors who had revascularization\n before<\/jats:italic>\n or\n after<\/jats:italic>\n an arrhythmic event. To evaluate the role of\n ICD<\/jats:styled-content>\n and the effects of clinical variables including degree of revascularization, we studied cardiac surgery patients who had an\n ICD<\/jats:styled-content>\n implanted for sustained perioperative ventricular arrhythmias.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n The electronic database for Southern California Kaiser Foundation hospitals was searched for patients who had cardiac surgery between 1999 and 2005 and an\n ICD<\/jats:styled-content>\n implanted within 3\u00a0months of surgery. One hundred sixty\u2010four patients were identified; 93\/164 had an\n ICD<\/jats:styled-content>\n for sustained pre\u2010 or postoperative ventricular tachycardia or fibrillation requiring resuscitation. Records were reviewed for the following: presenting arrhythmia, ejection fraction, and degree of revascularization. The primary end point was total mortality (\n TM<\/jats:styled-content>\n ) and\/or appropriate\n ICD<\/jats:styled-content>\n therapy (\n ICD<\/jats:styled-content>\n \u2010T), and secondary end points are\n TM<\/jats:styled-content>\n and\n ICD<\/jats:styled-content>\n \u2010T. During the mean follow up of 49\u00a0months, the primary endpoint of\n TM<\/jats:styled-content>\n +\n ICD<\/jats:styled-content>\n \u2010T and individual end points of\n TM<\/jats:styled-content>\n and\n ICD<\/jats:styled-content>\n \u2010T were observed in 52 (56%), 35 (38%), and 28 (30%) patients, respectively, with 55% of\n TM<\/jats:styled-content>\n , and 23% of\n ICD<\/jats:styled-content>\n \u2010T occurring within 2\u00a0years of implant. In multivariate risk analysis, none of the following was associated with any of the end points: incomplete revascularization, presenting ventricular arrhythmia, and timing of arrhythmias.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Our data supports the recent guidelines for\n ICD<\/jats:styled-content>\n in this cohort of patients, as the presence of irreversible substrate and triggers of ventricular arrhythmias, cannot be reliably excluded even with complete revascularization. Further studies are needed to understand this complex group of patients.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.113.000686","type":"journal-article","created":{"date-parts":[[2014,8,22]],"date-time":"2014-08-22T00:29:49Z","timestamp":1408667389000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Implantable Defibrillators for Secondary Prevention of Sudden Cardiac Death in Cardiac Surgery Patients With Perioperative Ventricular Arrhythmias"],"prefix":"10.1161","volume":"3","author":[{"given":"Maged F.","family":"Nageh","sequence":"first","affiliation":[{"name":"Department of Electrophysiology, Kaiser Permanente Southern California, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kaiser Permanente Southern California, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lie\u2010Hong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Research and Evaluation, Kaiser Permanente Southern California, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janis F.","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Research and Evaluation, Kaiser Permanente Southern California, Los Angeles, 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