{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T20:01:57Z","timestamp":1787688117600,"version":"build-2784847793"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,8,2]]},"abstract":"\n Background<\/jats:title>\n \n We sought to examine the mortality impact of appropriate implantable cardioverter defibrillator (\n ICD<\/jats:styled-content>\n ) therapy between patients who received\n ICD<\/jats:styled-content>\n for primary versus secondary prevention purposes.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n From a prospective, population\u2010based registry, we identified 7020 patients who underwent de novo\n ICD<\/jats:styled-content>\n implantation between February 2007 and May 2012 in Ontario, Canada. The primary outcome was all\u2010cause mortality. We used multivariable Cox proportional hazard modeling to adjust for differences in baseline characteristics and analyzed the mortality impact of first appropriate\n ICD<\/jats:styled-content>\n therapy (shock and antitachycardia pacing [\n ATP<\/jats:styled-content>\n ]) as a time\u2010varying covariate. There were 1929 (27.5%) patients who received\n ICD<\/jats:styled-content>\n s for secondary prevention purposes. The median follow\u2010up period was 5.02\u00a0years. Compared with those with secondary prevention\n ICD<\/jats:styled-content>\n s, patients with primary prevention\n ICD<\/jats:styled-content>\n s had more medical comorbidities, and lower ejection fraction. Patients who experienced appropriate\n ICD<\/jats:styled-content>\n shock or\n ATP<\/jats:styled-content>\n had greater risk of death compared with those who did not, irrespective of implant indication. In the primary prevention group, the adjusted hazard ratios of death for appropriate shock and\n ATP<\/jats:styled-content>\n were 2.00 (95%\n CI<\/jats:styled-content>\n : 1.72\u20132.33) and 1.73 (95%\n CI<\/jats:styled-content>\n : 1.52\u20131.97), respectively. In the secondary prevention group, the adjusted hazard ratios of death for appropriate\n ICD<\/jats:styled-content>\n shock and\n ATP<\/jats:styled-content>\n were 1.46 (95%\n CI<\/jats:styled-content>\n : 1.20\u20131.77) and 1.38 (95%\n CI<\/jats:styled-content>\n : 1.16\u20131.64), respectively.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Despite having a more favorable clinical profile, occurrence of appropriate\n ICD<\/jats:styled-content>\n shock or\n ATP<\/jats:styled-content>\n in patients with secondary prevention\n ICD<\/jats:styled-content>\n s was associated with similar magnitudes of mortality risk as those with primary prevention\n ICD<\/jats:styled-content>\n s. A heightened degree of care is warranted for all patients who experience appropriate\n ICD<\/jats:styled-content>\n shock or\n ATP<\/jats:styled-content>\n therapy.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.117.006220","type":"journal-article","created":{"date-parts":[[2017,9,1]],"date-time":"2017-09-01T18:25:38Z","timestamp":1504290338000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Mortality Implications of Appropriate Implantable Cardioverter Defibrillator Therapy in Secondary Prevention Patients: Contrasting Mortality in Primary Prevention Patients From a Prospective Population\u2010Based Registry"],"prefix":"10.1161","volume":"6","author":[{"given":"Fahad","family":"Almehmadi","sequence":"first","affiliation":[{"name":"University of Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreu","family":"Porta\u2010S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada"},{"name":"University of Toronto, Canada"},{"name":"Department de Medicina, Universitat de Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew C. T.","family":"Ha","sequence":"additional","affiliation":[{"name":"Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada"},{"name":"University of Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hadas D.","family":"Fischer","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuesong","family":"Wang","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter C.","family":"Austin","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences (ICES), Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas S.","family":"Lee","sequence":"additional","affiliation":[{"name":"Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada"},{"name":"University of Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumaraswamy","family":"Nanthakumar","sequence":"additional","affiliation":[{"name":"Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada"},{"name":"University of Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.2000.2476"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.000547"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2002.00580.x"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.09.073"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2010.02845.x"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa071098"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2009.11.027"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-014-9941-8"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2008.05.015"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.115.002414"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.08.020"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euq494"},{"key":"e_1_3_4_14_2","first-page":"760","article-title":"Incidence of implantable cardioverter defibrillator therapy and mortality in primary and secondary prevention of sudden cardiac death","volume":"17","author":"Konstantino Y","year":"2015","unstructured":"Konstantino Y, Shafat T, Novack V, Novack L, Amit G. 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Isr Med Assoc J. 2015;17:760\u2013763.","journal-title":"Isr Med Assoc J"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.02.058"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2010.03004.x"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199711273372202"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.4172\/2155\u20109880.1000105"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12860"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.114.001623"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61755-4"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.116.004422"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.001442"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.007270"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2015.06.019"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joa.2015.12.001"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.05.011"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.117.006220","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T10:51:53Z","timestamp":1715597513000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.117.006220"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,8,2]]},"references-count":26,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2017,8,2]]}},"alternative-id":["10.1161\/JAHA.117.006220"],"URL":"https:\/\/doi.org\/10.1161\/jaha.117.006220","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,8,2]]},"assertion":[{"value":"2017-03-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-06-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-08-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e006220"}}