{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T16:54:32Z","timestamp":1774371272804,"version":"3.50.1"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,4,3]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Primary prevention implantable cardioverter\u2010defibrillators (ICDs) reduce mortality in selected patients with left ventricular systolic dysfunction by delivering therapies (antitachycardia pacing or shocks) to terminate potentially lethal arrhythmias; inappropriate therapies also occur. We assessed device therapies among adults receiving primary prevention ICDs in 7 healthcare systems.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We linked medical record data, adjudicated device therapies, and the National Cardiovascular Data Registry ICD Registry. Survival analysis evaluated therapy probability and predictors after ICD implant from 2006 to 2009, with attention to Centers for Medicare and Medicaid Services Coverage With Evidence Development subgroups: left ventricular ejection fraction, 31% to 35%; nonischemic cardiomyopathy &lt;9\u00a0months\u2019 duration; and New York Heart Association class IV heart failure with cardiac resynchronization therapy defibrillator. Among 2540 patients, 35% were &lt;65\u00a0years old, 26% were women, and 59% were white. During 27 (median) months, 738 (29%) received \u22651 therapy. Three\u2010year therapy risk was 36% (appropriate, 24%; inappropriate, 12%). Appropriate therapy was more common in men (adjusted hazard ratio [HR], 1.84; 95% confidence interval [CI], 1.43\u20132.35). Inappropriate therapy was more common in patients with atrial fibrillation (adjusted HR, 2.20; 95% CI, 1.68\u20132.87), but less common among patients \u226565\u00a0years old versus younger (adjusted HR, 0.72; 95% CI, 0.54\u20130.95) and in recent implants (eg, in 2009 versus 2006; adjusted HR, 0.66; 95% CI, 0.46\u20130.95). In Centers for Medicare and Medicaid Services Coverage With Evidence Development analysis, inappropriate therapy was less common with cardiac resynchronization therapy defibrillator versus single chamber (adjusted HR, 0.55; 95% CI, 0.36\u20130.84); therapy risk did not otherwise differ for Centers for Medicare and Medicaid Services Coverage With Evidence Development subgroups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In this community cohort of primary prevention patients receiving ICD, therapy delivery varied across demographic and clinical characteristics, but did not differ meaningfully for Centers for Medicare and Medicaid Services Coverage With Evidence Development subgroups.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.117.008292","type":"journal-article","created":{"date-parts":[[2018,3,26]],"date-time":"2018-03-26T09:05:13Z","timestamp":1522055113000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Device Therapies Among Patients Receiving Primary Prevention Implantable Cardioverter\u2010Defibrillators in the Cardiovascular Research Network"],"prefix":"10.1161","volume":"7","author":[{"given":"Robert T.","family":"Greenlee","sequence":"first","affiliation":[{"name":"Marshfield Clinic, Marshfield, WI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan S.","family":"Go","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Northern California, Oakland, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela N.","family":"Peterson","sequence":"additional","affiliation":[{"name":"Denver Health Medical Center, Denver, CO"},{"name":"University of Colorado Anschutz Medical Campus, Aurora, CO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea E.","family":"Cassidy\u2010Bushrow","sequence":"additional","affiliation":[{"name":"Henry Ford Health System, Detroit, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles","family":"Gaber","sequence":"additional","affiliation":[{"name":"University of Michigan, Ann Arbor, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Romel","family":"Garcia\u2010Montilla","sequence":"additional","affiliation":[{"name":"Marshfield Clinic, Marshfield, WI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen A.","family":"Glenn","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Colorado, Denver, CO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nigel","family":"Gupta","sequence":"additional","affiliation":[{"name":"Kaiser Los Angeles Medical Center, Los Angeles, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerry H.","family":"Gurwitz","sequence":"additional","affiliation":[{"name":"University of Massachusetts Medical School, Worcester, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen C.","family":"Hammill","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Rochester, MN"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John J.","family":"Hayes","sequence":"additional","affiliation":[{"name":"Marshfield Clinic, Marshfield, WI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Kadish","sequence":"additional","affiliation":[{"name":"Touro College, New York, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Magid","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Colorado, Denver, CO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David D.","family":"McManus","sequence":"additional","affiliation":[{"name":"University of Massachusetts Medical School, Worcester, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Multerer","sequence":"additional","affiliation":[{"name":"Marshfield Clinic, Marshfield, WI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. David","family":"Powers","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Colorado, Denver, CO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liza M.","family":"Reifler","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Colorado, Denver, CO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristi","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Southern California, Pasadena, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Schuger","sequence":"additional","affiliation":[{"name":"University of Michigan, Ann Arbor, MI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Param P.","family":"Sharma","sequence":"additional","affiliation":[{"name":"Marshfield Clinic, Marshfield, WI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David H.","family":"Smith","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Northwest, Portland, OR"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Suits","sequence":"additional","affiliation":[{"name":"Marshfield Clinic, Marshfield, WI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sue Hee","family":"Sung","sequence":"additional","affiliation":[{"name":"Kaiser Permanente Northern California, Oakland, CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul D.","family":"Varosy","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs Eastern Colorado Health System, Denver, CO"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Humberto J.","family":"Vidaillet","sequence":"additional","affiliation":[{"name":"Marshfield Clinic, Marshfield, WI"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick A.","family":"Masoudi","sequence":"additional","affiliation":[{"name":"University of Colorado Anschutz Medical Campus, Aurora, CO"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199612263352601"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa013474"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043399"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12465"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa071098"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0706719"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.07.016"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2013.01.035"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(03)00189-3"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10840-007-9151-8"},{"key":"e_1_3_3_12_2","unstructured":"Centers for Medicare and Medicaid Services . 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