{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T06:20:21Z","timestamp":1783059621441,"version":"3.54.6"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The PRESERVE EF study proposed a two-step algorithm for risk stratification in post-myocardial infarction (MI) patients with mid-range and preserved left ventricular ejection fraction (LVEF). This method assessed the performance of a two-step, programmed ventricular stimulation (PVS)-inclusive approach in identifying high-risk post-MI patients with LVEF \u226540%. This report presents findings from the 8-year follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The primary endpoint was the occurrence of a major arrhythmic event, defined as sustained ventricular tachycardia\/fibrillation, appropriate implantable cardioverter-defibrillator (ICD) activation, or sudden cardiac death (SCD). We included a total of 575 consecutive patients (mean age 57\u2005years, LVEF 50.8%). Of them, 204 (35.5%) had at least one positive non-invasive risk factor. Forty-one of 152 patients undergoing PVS were inducible; 37 (90.2%) of them received an ICD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During a mean follow-up of 106\u2009\u00b1\u200914.5\u2005months, no SCDs were observed, while 12 ICDs (the major arrhythmic event prevalence in patients with ICD implantation reaching 29.3%) were appropriately activated. The updated performance metrics of the proposed approach were as follows: sensitivity 100% (95% CI: 73.5%\u2013100%), specificity 94.8% (95% CI: 92.5\u201396.5%), positive predictive value 29.3% (95% CI: 17.2\u201345.0%), and negative predictive value 100% (95% CI: 99.3%\u2013100%). Notably, events occurred only in patients with an LVEF 40%\u201350% and a history of ST-Elevation Myocardial Infarction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The PRESERVE EF study demonstrates that a simple, two-step, non-invasive risk factor-guided approach, followed by programmed ventricular stimulation, can effectively identify a subgroup of post-MI patients with preserved or mid-range LVEF \u226540 who are at high risk for major arrhythmic events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>Clinicaltrials.gov<\/jats:ext-link>\n                      , identifier NCT02124018.\n                    <\/jats:p>\n                  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