{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T03:42:24Z","timestamp":1771472544374,"version":"3.50.1"},"reference-count":64,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2015,10,29]]},"abstract":"\n Background<\/jats:title>\n \n It remains to be determined whether patients receiving cardiac resynchronization therapy (\n CRT<\/jats:styled-content>\n ) benefit from the addition of an implantable cardioverter\u2010defibrillator (\n ICD<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We performed a literature search looking for studies of patients implanted with\n CRT<\/jats:styled-content>\n s. Comparisons were performed between patients receiving\n CRT<\/jats:styled-content>\n \u2010defibrillator (\n CRT<\/jats:styled-content>\n \u2010D) versus\n CRT<\/jats:styled-content>\n \u2010pacemaker (\n CRT<\/jats:styled-content>\n \u2010P). The primary outcome was all\u2010cause mortality. Data were pooled using a random\u2010effects model. The relative risk (\n RR<\/jats:styled-content>\n ) and hazard ratio (\n HR<\/jats:styled-content>\n , when available) were used as measurements of treatment effect. Nineteen entries were entitled for inclusion, comprising 12\u00a0378 patients (7030 receiving\n CRT<\/jats:styled-content>\n \u2010D and 5348 receiving\n CRT<\/jats:styled-content>\n \u2010P) and 29\u00a0799 patient\u2010years of follow\u2010up. Those receiving\n CRT<\/jats:styled-content>\n \u2010D were younger, were more often males, had lower\n NYHA<\/jats:styled-content>\n class, lower prevalence of atrial fibrillation, higher prevalence of ischemic heart disease, and were more often on beta\u2010blockers. Ten studies showed significantly lower mortality rates with the\n CRT<\/jats:styled-content>\n \u2010D device, while the remaining 9 were neutral. The pooled data of studies revealed that\n CRT<\/jats:styled-content>\n \u2010D patients had significantly lower mortality rates compared with\n CRT<\/jats:styled-content>\n \u2010P patients (mortality rates:\n CRT<\/jats:styled-content>\n \u2010D 16.6% versus\n CRT<\/jats:styled-content>\n \u2010P 27.1%;\n RR<\/jats:styled-content>\n =0.69, 95%\n CI<\/jats:styled-content>\n 0.62\u20130.76;\n P<\/jats:italic>\n <0.00001). The number needed to treat to prevent one death was 10. The observed I\n 2<\/jats:sup>\n values showed moderate heterogeneity among studies (I\n 2<\/jats:sup>\n =48%). The benefit of\n CRT<\/jats:styled-content>\n \u2010D was more pronounced in ischemic cardiomyopathy (\n HR<\/jats:styled-content>\n =0.70, 95%\n CI<\/jats:styled-content>\n 0.59\u20130.83,\n P<\/jats:italic>\n <0.001, I\n 2<\/jats:sup>\n =0%), but a trend for benefit, albeit of lower magnitude, could also be seen in non\u2010ischemic dilated cardiomyopathy (\n HR<\/jats:styled-content>\n =0.79, 95%\n CI<\/jats:styled-content>\n 0.61\u20131.02,\n P<\/jats:italic>\n =0.07, I\n 2<\/jats:sup>\n =36%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n The addition of the\n ICD<\/jats:styled-content>\n associates with a reduction in the risk of all\u2010cause mortality in\n CRT<\/jats:styled-content>\n patients. This seems to be more pronounced in patients with ischemic cardiomyopathy.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.115.002539","type":"journal-article","created":{"date-parts":[[2015,11,7]],"date-time":"2015-11-07T03:18:44Z","timestamp":1446866324000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Importance of Implantable Cardioverter\u2010Defibrillator Back\u2010Up in Cardiac Resynchronization Therapy Recipients: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1161","volume":"4","author":[{"given":"S\u00e9rgio","family":"Barra","sequence":"first","affiliation":[{"name":"Cardiology Department, Papworth Hospital NHS Foundation Trust, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Provid\u00eancia","sequence":"additional","affiliation":[{"name":"Barts Heart Centre, Barts Health NHS Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Tang","sequence":"additional","affiliation":[{"name":"University of Western Ontario, London, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Heck","sequence":"additional","affiliation":[{"name":"Cardiology Department, Papworth Hospital NHS Foundation Trust, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Munmohan","family":"Virdee","sequence":"additional","affiliation":[{"name":"Cardiology Department, Papworth Hospital NHS Foundation Trust, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharad","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Cardiology Department, Papworth Hospital NHS Foundation Trust, Cambridge, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032423"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050496"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.113.000570"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0906431"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009540"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043399"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa033088"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013474"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)04440-2"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.07.087"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2004.04044.x"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.185"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eut032"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurjhf\/hfr158"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)01229-7"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2014-305537"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(02)03341-6"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eus247"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1080\/AC.68.1.2959630"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2010.12.091"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1080\/AC.69.5.3044874"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12631"},{"key":"e_1_3_4_24_2","article-title":"Adding the implantable cardioverter\u2010defibrillator to cardiac resynchronization therapy is associated with improved long\u2010term survival in ischemic, but not in non\u2010ischemic cardiomyopathy","author":"Witt C","year":"2015","unstructured":"Witt C, Kronborg M, Nohr E, Mortensen P, Gerdes C, Jensen H, Nielsen J. 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