{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T05:04:08Z","timestamp":1789535048095,"version":"build-2803163510"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"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:p>\n                    Chagas cardiomyopathy evolves through progressive myocardial injury that may alter the temporal distribution of arrhythmic risk compared with other dilated substrates. We analysed a two-centre registry of consecutive primary-prevention implantable cardioverter-defibrillator (ICD) recipients in Buenos Aires (2008\u20132025), excluding cardiomyopathies in which ICD indication is not based on ventricular dysfunction. The final cohort comprised 194 patients: 50 with Chagas cardiomyopathy (26%), 83 with ischaemic (43%) and 61 with non-ischaemic dilated cardiomyopathy (31%). Median LVEF was 30% in both groups. The primary endpoint was a composite of appropriate ICD therapy, adjudicated on stored electrograms, or all-cause death. Pre-planned analyses included multivariable Cox regression, period-specific models split at 5 years, competing-risk regression and restricted mean survival time (RMST). The endpoint occurred in 109 patients. Cumulative incidence was lower in Chagas patients at 1 year (2.1% vs. 12.2%) and 5 years (19.5% vs. 42.4%), and Chagas patients accumulated 682 additional event-free days at 10-year RMST (95% CI: 258\u20131047;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001). Chagas cardiomyopathy was associated with lower composite risk (hazard ratio 0.58; 95% CI: 0.37\u20130.91;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.018), an association confined to the first 5 years (0.35; 0.17\u20130.75;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.007) and no longer detectable thereafter (0.85; 0.47\u20131.54;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.587), with 28 and 56 patients at risk at 5 years and 11 and 20 at 10 years. The wide confidence interval and small population at risk in the late period mean that absence of a detectable difference should not be read as evidence of equivalent risk. These findings are hypothesis-generating and require confirmation in larger cohorts.\n                  <\/jats:p>","DOI":"10.3389\/fcvm.2026.1950508","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T04:29:19Z","timestamp":1789532959000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Temporal evolution of clinical event risk after primary-prevention ICD implantation: Chagas vs. non-Chagas dilated cardiomyopathy"],"prefix":"10.3389","volume":"13","author":[{"given":"Juan Pablo","family":"Guzm\u00e1n","sequence":"first","affiliation":[{"name":"Arrhythmia and Cardiac Pacing Section, Department of Cardiology, Hospital Churruca-Visca","place":["Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Diaz Uberti","sequence":"additional","affiliation":[{"name":"Arrhythmia and Cardiac Pacing Section, Department of Cardiology, Hospital Churruca-Visca","place":["Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila","family":"Rosello","sequence":"additional","affiliation":[{"name":"Arrhythmia and Cardiac Pacing Section, Department of Cardiology, Hospital Churruca-Visca","place":["Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maribel","family":"Capobianco","sequence":"additional","affiliation":[{"name":"Electrophysiology Service, Hospital Rivadavia","place":["Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Piazza","sequence":"additional","affiliation":[{"name":"Arrhythmia and Cardiac Pacing Section, Department of Cardiology, Hospital Churruca-Visca","place":["Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Di Tommaso","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Rivadavia","place":["Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Zubiri","sequence":"additional","affiliation":[{"name":"Arrhythmia and Cardiac Pacing Section, Department of Cardiology, Hospital Churruca-Visca","place":["Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Toscano","sequence":"additional","affiliation":[{"name":"Arrhythmia and Cardiac Pacing Section, Department of Cardiology, Hospital Churruca-Visca","place":["Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.1161\/CIRCRESAHA.124.324507","article-title":"Arrhythmogenic manifestations of Chagas disease: perspectives from the bench to bedside","volume":"134","author":"Roman-Campos","year":"2024","journal-title":"Circ 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