{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:19:08Z","timestamp":1790079548843,"version":"4.0.1"},"reference-count":22,"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":[[2021,1,5]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Large\u2010scale studies describing modern populations using an implantable cardioverter\u2010defibrillator (ICD) are lacking. We aimed to analyze the incidence of arrhythmia, device interventions, and mortality in a broad spectrum of real\u2010world ICD patients with different heart disorders.<\/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\">The UMBRELLA study is a prospective, multicenter, nationwide study of contemporary patients using an ICD followed up by remote monitoring, with a blinded review of arrhythmic episodes. From November 2005 to November 2017, 4296 patients were followed up. After 46.6\u00b127.3\u00a0months, 16\u00a0067 episodes of sustained ventricular arrhythmia occurred in 1344 patients (31.3%). Appropriate ICD therapy occurred in 27.3% of study population. Patients with ischemic cardiomyopathy (hazard ratio [HR], 1.51; 95% CI, 1.29\u20131.78), dilated cardiomyopathy (HR, 1.28; 95% CI, 1.07\u20131.53), and valvular heart disease (HR, 1.94; 95% CI, 1.43\u20132.62) exhibited a higher risk of appropriate ICD therapies, whereas patients with hypertrophic cardiomyopathy (HR, 0.72; 95% CI, 0.54\u20130.96) and Brugada syndrome (HR, 0.25; 95% CI, 0.14\u20130.45) showed a lower risk. All\u2010cause death was 13.4% at follow\u2010up. Ischemic cardiomyopathy (HR, 3.09; 95% CI, 2.58\u20135.90), dilated cardiomyopathy (HR, 3.33; 95% CI, 2.18\u20135.10), and valvular heart disease (HR, 3.97; 95% CI, 2.25\u20136.99) had the worst prognoses. Delayed high\u2010rate detection was enabled in 39.7% of patients, and single\u2010zone programming occurred in 52.6% of primary prevention patients. Both parameters correlated with lower risk of first appropriate ICD therapy, with no excess risk of mortality. The rate of inappropriate shocks at follow\u2010up was low (6%) and did not differ among type of ICD but was lower in SmartShock\u2010capable devices.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Irrespective of the cause, contemporary ICD patients with heart failure\u2013related disorders had a similar risk of ICD life\u2010saving interventions and death. Current ICD programming recommendations still need to be implemented.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NTC01561144.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.018108","type":"journal-article","created":{"date-parts":[[2020,12,25]],"date-time":"2020-12-25T10:00:16Z","timestamp":1608890416000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Long\u2010Term Outcomes Among a Nationwide Cohort of Patients Using an Implantable Cardioverter\u2010Defibrillator: UMBRELLA Study Final 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