{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:10:08Z","timestamp":1789017008347,"version":"build-2803163510"},"reference-count":61,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T00:00:00Z","timestamp":1618358400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: With the advent of implantable cardioverter-defibrillator (ICD) technology in recent decades, patients with inherited or congenital cardiomyopathy have a greater chance of survival into adulthood. Women with ICDs in this group are now more likely to reach reproductive age. However, pregnancy represents a challenge for clinicians, as no guidelines for the treatment of pregnant women with an ICD are currently available. Methods: To analyze this issue, we performed a systematic screening of the literature using the keywords: pregnancy with ICD, lead fracture in pregnancy, lead thrombi in pregnancy, ventricular tachycardia in pregnancy, inappropriate shocks in pregnancy, ICD discharge in pregnancy and ICD shock in pregnancy. Of 1101 publications found, 27 publications were eligible for further analysis (four retrospective trials and 23 case reports). Results: According to physiological changes in pregnancy, resulting in an increase in heart rate and cardiac output, a vulnerability for malignant arrhythmias and device-related complications in ICD carriers might be suspected. While the literature is limited on this issue, maternal complications including arrhythmia burden with following ICD therapies, thromboembolic events and lead complications as well as inappropriate shock therapy have been reported. According to the limited available studies, associated risk seems not to be more frequent than in the general population and depends on the underlying cardiac pathology. Furthermore, worsening of heart failure and related cardiovascular disease have been reported with associated risk of preterm delivery. These observations are exaggerated by restricted applications of diagnostics and treatment due to the risk of fetal harm in this population. Conclusions: Due to limited data on management of ICDs during pregnancy, further scientific investigations are required. Consequently, careful risk assessment with individual risk evaluation and close follow ups with interdisciplinary treatment are recommended in pregnant ICD carriers.<\/jats:p>","DOI":"10.3390\/jcm10081675","type":"journal-article","created":{"date-parts":[[2021,4,14]],"date-time":"2021-04-14T04:21:08Z","timestamp":1618374068000},"page":"1675","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Management of Implantable Cardioverter-Defibrillators during Pregnancy\u2014A Systematic Review"],"prefix":"10.3390","volume":"10","author":[{"given":"Albert","family":"Topf","sequence":"first","affiliation":[{"name":"Department of Internal Medicine II, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina","family":"Bacher","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen","family":"Kopp","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5679-4872","authenticated-orcid":false,"given":"Moritz","family":"Mirna","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Larbig","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Hospital Maria Hilf M\u00f6nchengladbach, 41063 M\u00f6nchengladbach, Germany"},{"name":"Division of Electrophysiology, Department of Cardiovascular Medicine, University of M\u00fcnster, 48149 M\u00fcnster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias C.","family":"Brandt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Kraus","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uta C.","family":"Hoppe","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas J.","family":"Motloch","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Lichtenauer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e320","DOI":"10.1097\/AOG.0000000000003243","article-title":"ACOG Practice Bulletin No. 212: Pregnancy and Heart Disease","volume":"133","author":"Hollier","year":"2019","journal-title":"Obstet. Gynecol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1253\/circj.CJ-13-0293","article-title":"Implantable cardioverter defibrillator therapy during pregnancy\u2014Is it safe and effective?","volume":"77","author":"Ishikawa","year":"2013","journal-title":"Circ. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2996","DOI":"10.19102\/icrm.2018.090103","article-title":"The Use of Implantable Cardioverter-defibrillators in the Prevention of Sudden Cardiac Death: A Focus on Congenital Heart Disease and Inherited Arrhythmia Syndromes","volume":"9","author":"Goldstein","year":"2018","journal-title":"J. Innov. Card. Rhythm Manag."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"238","DOI":"10.14797\/mdcj-13-4-238","article-title":"Congenital Heart Disease and Reproductive Risk: An Overview for Obstetricians, Cardiologists, and Primary Care Providers","volume":"13","author":"Phillips","year":"2017","journal-title":"Methodist DeBakey Cardiovasc. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.ijcard.2016.06.061","article-title":"Ventricular tachyarrhythmia during pregnancy in women with heart disease: Data from the ROPAC, a registry from the European Society of Cardiology","volume":"220","author":"Ertekin","year":"2016","journal-title":"Int. J. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.jacc.2009.08.036","article-title":"Pregnancy Outcomes in Women with Dilated Cardiomyopathy","volume":"55","author":"Grewal","year":"2009","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e393","DOI":"10.2196\/jmir.8066","article-title":"Bioimpedance Alerts from Cardiovascular Implantable Electronic Devices: Observational Study of Diagnostic Relevance and Clinical Outcomes","volume":"19","author":"Smeets","year":"2017","journal-title":"J. Med. Internet Res."},{"key":"ref_8","first-page":"1904","article-title":"Diagnosis, family screening, and treatment of inherited arrhythmogenic diseases in Europe: Results of the European Heart Rhythm Association Survey","volume":"22","author":"Conte","year":"2020","journal-title":"EP Eur."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2793","DOI":"10.1093\/eurheartj\/ehv316","article-title":"2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac Death. The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology","volume":"36","author":"Priori","year":"2015","journal-title":"Eur. Heart J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3165","DOI":"10.1093\/eurheartj\/ehy340","article-title":"2018 ESC Guidelines for the management of cardiovascular diseases during pregnancy","volume":"39","author":"Bauersachs","year":"2018","journal-title":"Eur. Hearth J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1002\/ejhf.627","article-title":"September 2016 at a glance: Pregnancy, hypertrophic cardiomyopathy, epidemiology, medical treatment","volume":"18","author":"Metra","year":"2016","journal-title":"Eur. J. Hearth Fail."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2501","DOI":"10.1253\/circj.CJ-14-0541","article-title":"Cardiovascular Events in Pregnancy with Hypertrophic Cardiomyopathy","volume":"78","author":"Tanaka","year":"2014","journal-title":"Circ. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3147","DOI":"10.1093\/eurheartj\/ehr218","article-title":"ESC Guidelines on the management of cardiovascular diseases during pregnancy: The Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC)","volume":"32","author":"Lundqvist","year":"2011","journal-title":"Eur. Hearth J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1543","DOI":"10.1136\/heartjnl-2018-313476","article-title":"Cardiomyopathy and pregnancy","volume":"105","author":"Schaufelberger","year":"2019","journal-title":"Hearth"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1111\/j.1447-0756.2010.01378.x","article-title":"Pregnancy and subsequent pregnancy outcomes in peripartum cardiomyopathy","volume":"37","author":"Mandal","year":"2010","journal-title":"J. Obstet. Gynaecol. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s12471-011-0209-y","article-title":"The pregnant woman with heart disease: Management of pregnancy and delivery","volume":"20","author":"Pieper","year":"2011","journal-title":"Neth. Hearth J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"20","DOI":"10.15420\/cfr.2015:24:2","article-title":"Decompensated Heart Failure in Pregnancy","volume":"2","author":"Sliwa","year":"2016","journal-title":"Card. Fail. Rev."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2808","DOI":"10.1161\/01.CIR.96.9.2808","article-title":"Implantable cardioverter-defibrillators and pregnancy: A safe combination?","volume":"96","author":"Natale","year":"1997","journal-title":"Circulation"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1253\/circj.CJ-12-1275","article-title":"Safety and Efficacy of Implantable CardioverterDefibrillator During Pregnancy and After Delivery","volume":"77","author":"Miyoshi","year":"2013","journal-title":"Circ. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1587","DOI":"10.1093\/europace\/euu036","article-title":"Pregnancy in women with an implantable cardioverter-defibrillator: Is it safe?","volume":"16","author":"Ovart","year":"2014","journal-title":"Europace"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1740","DOI":"10.1093\/europace\/eus172","article-title":"Pregnancy outcome and management of women with an implantable cardioverter defibrillator: A single centre experience","volume":"14","author":"Schuler","year":"2012","journal-title":"Europace"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"236","DOI":"10.11604\/pamj.2018.30.236.9995","article-title":"Pregnancy and delivery in woman with implantable cardioverter-defibrillator: What we should know","volume":"30","author":"Bouslama","year":"2018","journal-title":"Pan Afr. Med. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"A752","DOI":"10.1016\/S0735-1097(15)60752-5","article-title":"ICD Management During Pregnancy and Delivery","volume":"65","author":"Howell","year":"2015","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1007\/s00404-008-0854-6","article-title":"Caesarean delivery in a parturient with Holt\u2013Oram syndrome and implantable cardioverter defibrillator: Anaesthetic considerations","volume":"280","author":"Kanniah","year":"2008","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Luo, F.Y., Chadha, R., Osborne, C., and Kealey, A. (2020). Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) in pregnancy: A case series of nine patients and review of literature. J. Matern. Neonatal Med., 1\u20139.","DOI":"10.1080\/14767058.2020.1745176"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1053\/eupc.1999.0063","article-title":"Pregnancy with an ICD and a documented ICD discharge","volume":"2","author":"Bonini","year":"2000","journal-title":"Europace"},{"key":"ref_27","first-page":"e77","article-title":"Pregnancy and Short-Coupled Torsades de Pointes","volume":"36","author":"Burrows","year":"2010","journal-title":"Pacing Clin. Electrophysiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1002\/ccr3.366","article-title":"Teenage pregnancy with catecholaminergic polymorphic ventricular tachycardia and documented ICD discharges","volume":"4","author":"Ahmed","year":"2016","journal-title":"Clin. Case Rep."},{"key":"ref_29","first-page":"176","article-title":"The Clinical Significance of Pregnancy in Brugada Syndrome","volume":"67","author":"Sarkozy","year":"2014","journal-title":"Rev. Espa\u00f1ola Cardiol. (Engl. Ed.)"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1016\/j.ijoa.2017.07.011","article-title":"Anaesthetic management of pregnant patients with cardiac implantable electronic devices: Case reports and review","volume":"33","author":"Salman","year":"2018","journal-title":"Int. J. Obstet. Anesth."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13256-020-02569-5","article-title":"Catecholaminergic polymorphic ventricular tachycardia in pregnancy: A case report","volume":"14","author":"Schumer","year":"2020","journal-title":"J. Med. Case Rep."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2016\/4690790","article-title":"A Pregnancy with Severe Hypertrophic Obstructive Cardiomyopathy after Surgery for an Implantable Cardioverter Defibrillator: A Case Report and Literature Review","volume":"2016","author":"Mitsui","year":"2016","journal-title":"Case Rep. Obstet. Gynecol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"656","DOI":"10.5603\/KP.2014.0138","article-title":"Pregnancy-related physiological changes in cardiovascular system observed with implantable cardioverter-defibrillator","volume":"72","author":"Michalak","year":"2014","journal-title":"Kardiol. Pol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1007\/BF03018486","article-title":"Spinal anesthesia for Cesarean section in a parturient with long QT syndrome","volume":"51","author":"Gunka","year":"2004","journal-title":"Can. J. Anaesth."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1080\/14767050500226500","article-title":"Arrhythmogenic right ventricular cardiomyopathy with implantable cardioverter defibrillator placement in pregnancy","volume":"18","author":"Doyle","year":"2005","journal-title":"J. Matern. Neonatal Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1093\/bja\/aef230","article-title":"Use of implantable cardioverter defibrillator and anti-arrhythmic agents in a parturient","volume":"89","author":"Olufolabi","year":"2002","journal-title":"Br. J. Anaesth."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1007\/BF03086154","article-title":"Recurrence of cardiac arrest after 14 years without ICD interventions: A VF cluster immediately after delivery","volume":"16","author":"Knops","year":"2008","journal-title":"Neth. Hearth J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/S0002-9378(11)91439-2","article-title":"Pregnancy complicated by chronic cardiomyopathy and an automatic implantable cardioverter defibrillator","volume":"167","author":"Piper","year":"1992","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"351.e1","DOI":"10.1016\/j.repc.2017.09.019","article-title":"Autonomic cardiovascular control and cardiac arrhythmia in two pregnant women with hypertrophic cardiomyopathy: Insights from ICD monitoring","volume":"37","author":"Francia","year":"2018","journal-title":"Rev. Port. Cardiol."},{"key":"ref_40","first-page":"26","article-title":"Successful delivery by a cesarean section in a parturient with severe dilated cardiomyopathy, an implantable cardioverter defibrillator, and a repaired tetralogy of fallot","volume":"12","author":"Alnabti","year":"2011","journal-title":"Heart Views Off. J. Gulf Heart Assoc."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"401","DOI":"10.31486\/toj.18.0046","article-title":"Refractory Ventricular Tachycardia from Coronary Vasospasm During Pregnancy","volume":"19","author":"Ergle","year":"2019","journal-title":"Ochsner J."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"843","DOI":"10.1007\/s00101-015-0082-y","article-title":"Completely subcutaneous implantable cardioverter defibrillator: Care of S-ICD wearers during childbirth","volume":"64","author":"Strewe","year":"2015","journal-title":"Anaesthesist"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1136\/heartjnl-2015-308624","article-title":"Pregnancy course and outcomes in women with arrhythmogenic right ventricular cardiomyopathy","volume":"102","author":"Hodes","year":"2015","journal-title":"Hearth"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.ijcard.2016.08.097","article-title":"Interdisciplinary management of left ventricular hypertrabeculation\/noncompaction during pregnancy with a wearable defibrillator","volume":"223","author":"Reuschel","year":"2016","journal-title":"Int. J. Cardiol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1002\/ejhf.188","article-title":"Risk for ventricular fibrillation in peripartum cardiomyopathy with severely reduced left ventricular function-value of the wearable cardioverter\/defibrillator","volume":"16","author":"Duncker","year":"2014","journal-title":"Eur. J. Hearth Fail."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.cardfail.2011.09.004","article-title":"Characteristics and Outcomes of Peripartum Versus Nonperipartum Cardiomyopathy in Women Using a Wearable Cardiac Defibrillator","volume":"18","author":"Saltzberg","year":"2012","journal-title":"J. Card. Fail."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e50","DOI":"10.1161\/CIR.0000000000000458","article-title":"Management of Pregnancy in Patients with Complex Congenital Heart Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association","volume":"135","author":"Canobbio","year":"2017","journal-title":"Circulation"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.hrthm.2019.08.004","article-title":"Caring for the pregnant woman with an inherited arrhythmia syndrome","volume":"17","author":"Roston","year":"2020","journal-title":"Heart Rhythm"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1603","DOI":"10.1111\/jch.13397","article-title":"Beta-blocker subtypes and risk of low birth weight in newborns","volume":"20","author":"Duan","year":"2018","journal-title":"J. Clin. Hypertens."},{"key":"ref_50","first-page":"1630","article-title":"Managing palpitations and arrhythmias during pregnancy","volume":"93","author":"Adamson","year":"2007","journal-title":"Heart"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"209","DOI":"10.14797\/mdcj-13-4-209","article-title":"Pregnancy in Women with Cardiovascular Diseases","volume":"13","author":"Adam","year":"2017","journal-title":"Methodist DeBakey Cardiovasc. J."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1093\/bja\/aeh004","article-title":"Supraventricular tachycardia in pregnancy","volume":"92","author":"Robins","year":"2004","journal-title":"Br. J. Anaesth."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.ipej.2019.02.007","article-title":"Fetal arrhythmias: Diagnosis and management","volume":"19","author":"Batra","year":"2019","journal-title":"Indian Pacing Electrophysiol. J."},{"key":"ref_54","first-page":"1","article-title":"Tachyarrhythmias and pregnancy","volume":"9","author":"Merino","year":"2011","journal-title":"E J. Cardiol. Pract."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Karim, F., Ali, N.B., Khan, A.N.S., Hassan, A., Hasan, M.M., Hoque, D.M.E., Billah, S.M., El Arifeen, S., and Chowdhury, M.A.K. (2020). Prevalence and factors associated with caesarean section in four Hard-to-Reach areas of Bangladesh: Findings from a cross-sectional survey. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0234249"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1097\/AOG.0b013e31820cab69","article-title":"Effect of Maternal Heart Disease on Fetal Growth","volume":"117","author":"Gelson","year":"2011","journal-title":"Obstet. Gynecol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/j.jjcc.2011.11.006","article-title":"Risk factors associated with preterm delivery in women with cardiac disease","volume":"59","author":"Makino","year":"2012","journal-title":"J. Cardiol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/S0002-9149(02)03007-2","article-title":"Prevalence and significance of lead-related thrombi in patients with implantable cardioverter defibrillators","volume":"91","author":"Chow","year":"2003","journal-title":"Am. J. Cardiol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1023\/A:1017920112995","article-title":"Arrhythmias occurring during pregnancy","volume":"6","author":"Page","year":"2002","journal-title":"Card. Electrophysiol. Rev."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1186\/s12959-017-0135-3","article-title":"Reduced cardiac function and risk of venous thromboembolism in Asian countries","volume":"15","author":"Zhu","year":"2017","journal-title":"Thromb. J."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.joa.2013.04.001","article-title":"Pacemaker lead fracture without an increase in lead impedance caused by cardiac fibroma","volume":"29","author":"Sato","year":"2013","journal-title":"J. Arrhythmia"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/8\/1675\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:47:45Z","timestamp":1760161665000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/8\/1675"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,14]]},"references-count":61,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2021,4]]}},"alternative-id":["jcm10081675"],"URL":"https:\/\/doi.org\/10.3390\/jcm10081675","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,14]]}}}