{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:07Z","timestamp":1787018107006,"version":"build-2736575974"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Routine addition of an atrial lead during an implantable cardioverter\u2010defibrillator (ICD) implantation for primary prevention of sudden cardiac death, in patients without pacing indications, was not shown beneficial in contemporary studies. We aimed to investigate the use and safety of single\u2010 versus dual\u2010chamber ICD implantations in these patients.<\/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\">\n                      Using the National Inpatient Sample database, we identified patients with no pacing indications who underwent primary\u2010prevention ICD implantation in the United States between 2015 and 2019. Sociodemographic and clinical characteristics, as well as in\u2010hospital complications, were analyzed. Multivariable logistic regression was used to identify predictors of in\u2010hospital complications. An estimated total of 15\u2009940 patients, underwent ICD implantation for primary prevention of sudden cardiac death during the study period, 8860 (55.6%) received a dual\u2010chamber ICD. The mean age was 64\u2009years, and 66% were men. In\u2010hospital complication rates in the dual\u2010chamber ICD and single\u2010chamber ICD group were 12.8% and 10.7%, respectively (\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001), driven by increased rates of pneumothorax\/hemothorax (4.6% versus 3.4%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) and lead dislodgement (3.6% versus 2.3%;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) in the dual\u2010chamber ICD group. Multivariable analyses confirmed atrial lead addition as an independent predictor for \u201cany complications\u201d (odds ratio [OR], 1.1 [95% CI, 1.0\u20131.2]), for pneumo\/hemothorax (odds ratio, 1.1 [95% CI, 1.0\u20131.4]), and for lead dislodgement (odds ratio, 1.3 [95% CI, 1.1\u20131.6]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Despite lack of evidence for clinical benefit, dual\u2010chamber ICDs are implanted for primary prevention of sudden cardiac death in a majority of patients who do not have pacing indication. This practice is associated with increased risk of periprocedural complications. Avoidance of routine implantation of atrial leads will likely improve safety outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.122.029126","type":"journal-article","created":{"date-parts":[[2023,7,31]],"date-time":"2023-07-31T06:35:40Z","timestamp":1690785340000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":12,"title":["Single\u2010 Versus Dual\u2010Chamber Implantable Cardioverter\u2010Defibrillator for Primary Prevention of Sudden Cardiac Death in the United States"],"prefix":"10.1161","volume":"12","author":[{"given":"Gilad","family":"Margolis","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Hillel Yaffe Medical Center The Ruth and Bruce Rappaport Faculty of Medicine Technion Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nashed","family":"Hamuda","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, 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