{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T20:07:44Z","timestamp":1783627664062,"version":"3.55.0"},"reference-count":57,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,11,20]]},"abstract":"\n Background<\/jats:title>\n \n Implantable cardioverter\u2010defibrillator (\n ICD<\/jats:styled-content>\n ) improves survival when used for primary or secondary prevention of sudden cardiac death. Whether the benefits of\n ICD<\/jats:styled-content>\n in patients with atrial fibrillation (\n AF)<\/jats:styled-content>\n are similar to those with normal sinus rhythm (\n NSR<\/jats:styled-content>\n ) is not well established. The aim of this study is to investigate whether\n ICD<\/jats:styled-content>\n patients with\n AF<\/jats:styled-content>\n are at higher risk of mortality and appropriate shock therapy compared with patients with\n NSR<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Literature was searched and 25 observational studies with 63\u00a0283 patients were included in this meta\u2010analysis. We compared the outcomes of (1) all\u2010cause mortality and appropriate shock therapy among\n AF<\/jats:styled-content>\n and\n NSR<\/jats:styled-content>\n patients who received\n ICD<\/jats:styled-content>\n for either primary or secondary prevention and (2) all\u2010cause mortality among\n AF<\/jats:styled-content>\n patients with\n ICD<\/jats:styled-content>\n versus guideline directed medical therapy. All\u2010cause mortality (odds ratio, 2.11; 95% confidence interval, 1.73\u20132.56;\n P<\/jats:italic>\n <0.001) and incidence of appropriate shock therapy (odds ratio, 1.77; 95% confidence interval, 1.47\u20132.13;\n P<\/jats:italic>\n <0.001) were significantly higher in\n ICD<\/jats:styled-content>\n patients with\n AF<\/jats:styled-content>\n as compared to\n NSR<\/jats:styled-content>\n . There was no statistically significant mortality benefit from\n ICD<\/jats:styled-content>\n compared with medical therapy in\n AF<\/jats:styled-content>\n patients (odds ratio, 0.69; 95% confidence interval, 0.42\u20131.11;\n P<\/jats:italic>\n =0.12) based on a separate meta\u2010analysis of 3 studies with 387 patients.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Overall mortality and appropriate shock therapy are higher in\n ICD<\/jats:styled-content>\n patients with AF as compared with\n NSR<\/jats:styled-content>\n . The impact of\n ICD<\/jats:styled-content>\n on all\u2010cause mortality in\n AF<\/jats:styled-content>\n patients when compared to goal\u2010directed medical therapy is unclear, and randomized controlled trials are needed comparing\n AF<\/jats:styled-content>\n patients with\n ICD<\/jats:styled-content>\n and those who have indications for\n ICD,<\/jats:styled-content>\n but are only on medical therapy.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.118.010156","type":"journal-article","created":{"date-parts":[[2018,12,16]],"date-time":"2018-12-16T20:51:29Z","timestamp":1544993489000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Atrial Fibrillation Is Associated With Higher Overall Mortality in Patients With Implantable Cardioverter\u2010Defibrillator: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1161","volume":"7","author":[{"given":"Usman","family":"Mustafa","sequence":"first","affiliation":[{"name":"The Department of Medicine\/Division of Cardiology and Center for Cardiovascular Diseases & Sciences Louisiana State University Health Sciences Center\u2010Shreveport (LSUHSC\u2010S) Shreveport LA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parinita","family":"Dherange","sequence":"additional","affiliation":[{"name":"The Department of Medicine\/Division of Cardiology and Center for Cardiovascular Diseases & Sciences Louisiana State University Health Sciences Center\u2010Shreveport (LSUHSC\u2010S) Shreveport LA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Reddy","sequence":"additional","affiliation":[{"name":"The Department of Medicine\/Division of Cardiology and Center for Cardiovascular Diseases & Sciences Louisiana State University Health Sciences Center\u2010Shreveport (LSUHSC\u2010S) 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