{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T05:00:39Z","timestamp":1784869239256,"version":"3.55.0"},"reference-count":32,"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":[[2021,4,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">One third of primary prevention implantable cardioverter\u2010defibrillator patients receive appropriate therapy, but all remain at risk of defibrillator complications. Information on these complications in contemporary cohorts is limited. This study assessed complications and their risk factors after defibrillator implantation in a Dutch nationwide prospective registry cohort and forecasts the potential reduction in complications under distinct scenarios of updated indication criteria.<\/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\">Complications in a prospective multicenter registry cohort of 1442 primary implantable cardioverter\u2010defibrillator implant patients were classified as major or minor. The potential for reducing complications was derived from a newly developed prediction model of appropriate therapy to identify patients with a low probability of benefitting from the implantable cardioverter\u2010defibrillator. During a follow\u2010up of 2.2\u00a0years (interquartile range, 2.0\u20132.6 years), 228 complications occurred in 195 patients (13.6%), with 113 patients (7.8%) experiencing at least one major complication. Most common ones were lead related (n=93) and infection (n=18). Minor complications occurred in 6.8% of patients, with lead\u2010related (n=47) and pocket\u2010related (n=40) complications as the most prevailing ones. A surgical reintervention or additional hospitalization was required in 53% or 61% of complications, respectively. Complications were strongly associated with device type. Application of stricter implant indication results in a comparable proportional reduction of (major) complications.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">One in 13 patients experiences at least one major implantable cardioverter\u2010defibrillator\u2013related complication, and many patients undergo a surgical reintervention. Complications are related to defibrillator implantations, and these should be discussed with the patient. Stricter implant indication criteria and careful selection of device type implanted may have significant clinical and financial benefits.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.018063","type":"journal-article","created":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T10:21:28Z","timestamp":1617186088000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Dutch Outcome in Implantable Cardioverter\u2010Defibrillator Therapy: Implantable Cardioverter\u2010Defibrillator\u2013Related Complications in a Contemporary Primary Prevention Cohort"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4672-2477","authenticated-orcid":false,"given":"Marit","family":"van Barreveld","sequence":"first","affiliation":[{"name":"Department of Cardiology, Heart Center Amsterdam UMC, University of Amsterdam the Netherlands"},{"name":"Department of Epidemiology and Data Science Amsterdam UMC, University of Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4340-6815","authenticated-orcid":false,"given":"Tom E.","family":"Verstraelen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center Amsterdam UMC, University of Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8332-3336","authenticated-orcid":false,"given":"Pascal F. H. M.","family":"van Dessel","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Thorax Center Twente Medisch Spectrum Twente Enschede the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4591-4220","authenticated-orcid":false,"given":"Lucas V. A.","family":"Boersma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Center Amsterdam UMC, University of Amsterdam the Netherlands"},{"name":"Cardiology Department St. Antonius Ziekenhuis Nieuwegein Nieuwegein the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Paul H. M.","family":"Delnoy","sequence":"additional","affiliation":[{"name":"Department of Cardiology Isala Klinieken Zwolle the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3038-715X","authenticated-orcid":false,"given":"Anton E.","family":"Tuinenburg","sequence":"additional","affiliation":[{"name":"Division of Heart and Lungs Department of Cardiology University Medical Centre Utrecht the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5160-9700","authenticated-orcid":false,"given":"Dominic A. M. J.","family":"Theuns","sequence":"additional","affiliation":[{"name":"Department of Cardiology Erasmus MC Rotterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pepijn H.","family":"van der Voort","sequence":"additional","affiliation":[{"name":"Department of Cardiology Catharina Ziekenhuis Eindhoven Eindhoven the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert\u2010Jan","family":"Kimman","sequence":"additional","affiliation":[{"name":"Department of Cardiology Noordwest Ziekenhuisgroep Alkmaar the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Buskens","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University Medical Centre Groningen Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0361-3139","authenticated-orcid":false,"given":"Aeilko H.","family":"Zwinderman","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Data Science Amsterdam UMC, University of Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0528-0852","authenticated-orcid":false,"given":"Arthur A. 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