{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T05:21:29Z","timestamp":1793337689994,"version":"4.5.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,1,11]]},"abstract":"\n Background<\/jats:title>\n \n Optimal timing of implantation of an implantable cardioverter\/defibrillator (\n ICD<\/jats:styled-content>\n ) after newly diagnosed heart failure is unclear given that late reverse remodelling may occur. We aimed to analyze left ventricular ejection fraction (\n LVEF<\/jats:styled-content>\n ) after diagnosis of an\n LVEF<\/jats:styled-content>\n \u226435% during optimization of heart failure drug therapy.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n One hundred fifty\u2010six patients with newly diagnosed\n LVEF<\/jats:styled-content>\n \u226435% receiving a wearable cardioverter\/defibrillator (\n WCD<\/jats:styled-content>\n ) were analyzed.\n WCD<\/jats:styled-content>\n was prescribed for 3\u00a0months until first re\u2010evaluation. Indications for prolongation of\n WCD<\/jats:styled-content>\n wearing period instead of\n ICD<\/jats:styled-content>\n implantation were: (1)\n LVEF<\/jats:styled-content>\n at 3\u2010month visit 30% to 35%; (2) increase in\n LVEF<\/jats:styled-content>\n of \u22655% compared to the last visit; and (3) nonoptimized heart failure medication. Mean\n LVEF<\/jats:styled-content>\n was 24\u00b17% at diagnosis and 39\u00b111% at last follow\u2010up (mean, 12\u00b110\u00a0months). Whereas 88 patients presented a primary preventive\n ICD<\/jats:styled-content>\n indication (\n LVEF<\/jats:styled-content>\n \u226435%) at 3\u2010month follow\u2010up, only 58 showed a persistent primary preventive\n ICD<\/jats:styled-content>\n indication at last follow\u2010up. This delayed improvement in\n LVEF<\/jats:styled-content>\n was related to nonischemic origin of cardiomyopathy, New York Heart Association functional class at baseline, heart rate, better\n LVEF<\/jats:styled-content>\n after 3\u00a0months, and higher dosages of mineralocorticoid receptor antagonist. Twelve appropriate\n WCD<\/jats:styled-content>\n shocks for ventricular tachycardia\/ventricular fibrillation occurred in 11 patients. Two patients suffered from ventricular tachycardia\/ventricular fibrillation beyond 3\u00a0months after diagnosis.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n A relevant proportion of patients with newly diagnosed heart failure shows recovery of\n LVEF<\/jats:styled-content>\n >35% beyond 3\u00a0months after initiation of heart failure therapy. To avoid untimely\n ICD<\/jats:styled-content>\n implantation, prolongation of\n WCD<\/jats:styled-content>\n period should be considered in these patients to prevent sudden cardiac death while allowing left ventricular reverse remodeling during intensified drug therapy.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.004512","type":"journal-article","created":{"date-parts":[[2017,1,17]],"date-time":"2017-01-17T21:52:15Z","timestamp":1484689935000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":85,"title":["Avoiding Untimely Implantable Cardioverter\/Defibrillator Implantation by Intensified Heart Failure Therapy Optimization Supported by the Wearable Cardioverter\/Defibrillator\u2014The PROLONG Study"],"prefix":"10.1161","volume":"6","author":[{"given":"David","family":"Duncker","sequence":"first","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thorben","family":"K\u00f6nig","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Hohmann","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johann","family":"Bauersachs","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Veltmann","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehv316"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.592"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa041489"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0901889"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2012.07.004"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043938"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.009924"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12868"},{"key":"e_1_3_2_10_2","first-page":"69","article-title":"The wearable cardioverter\/defibrillator\u2014Toy or Tool?","volume":"8","author":"Duncker D","year":"2016","unstructured":"Duncker D, Veltman C. 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