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Association Between Use of Primary-Prevention Implantable Cardioverter-Defibrillators and Mortality in Patients With Heart Failure: A Prospective Propensity Score-Matched Analysis From the Swedish Heart Failure Registry.

https://arctichealth.org/en/permalink/ahliterature309191
Source
Circulation. 2019 11 05; 140(19):1530-1539
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
11-05-2019
Author
Benedikt Schrage
Alicia Uijl
Lina Benson
Dirk Westermann
Marcus Ståhlberg
Davide Stolfo
Ulf Dahlström
Cecilia Linde
Frieder Braunschweig
Gianluigi Savarese
Author Affiliation
Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden (B.S., A.U., L.B., M.S., D.S., C.L., F.B., G.S.).
Source
Circulation. 2019 11 05; 140(19):1530-1539
Date
11-05-2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Aged, 80 and over
Death, Sudden, Cardiac - epidemiology - prevention & control
Defibrillators, Implantable - trends
Electric Countershock - adverse effects - instrumentation - mortality - trends
Female
Heart Failure - diagnosis - mortality - physiopathology - therapy
Humans
Male
Middle Aged
Practice Patterns, Physicians' - trends
Primary Prevention - trends
Propensity Score
Registries
Risk assessment
Risk factors
Sweden - epidemiology
Time Factors
Treatment Outcome
Abstract
Most randomized trials on implantable cardioverter-defibrillator (ICD) use for primary prevention of sudden cardiac death in heart failure with reduced ejection fraction enrolled patients >20 years ago. We investigated the association between ICD use and all-cause mortality in a contemporary heart failure with reduced ejection fraction cohort and examined relevant subgroups.
Patients from the Swedish Heart Failure Registry fulfilling the European Society of Cardiology criteria for primary-prevention ICD were included. The association between ICD use and 1-year and 5-year all-cause and cardiovascular (CV) mortality was assessed by Cox regression models in a 1:1 propensity score-matched cohort and in prespecified subgroups.
Of 16?702 eligible patients, only 1599 (10%) had an ICD. After matching, 1305 ICD recipients were compared with 1305 nonrecipients. ICD use was associated with a reduction in all-cause mortality risk within 1 year (hazard ratio, 0.73 [95% CI, 0.60-0.90]) and 5 years (hazard ratio, 0.88 [95% CI, 0.78-0.99]). Results were consistent in all subgroups including patients with versus without ischemic heart disease, men versus women, those aged
Notes
CommentIn: Circulation. 2019 Nov 5;140(19):1540-1542 PMID 31476898
CommentIn: Circulation. 2020 Mar 17;141(11):e648-e649 PMID 32176544
CommentIn: Circulation. 2020 Mar 17;141(11):e646-e647 PMID 32176545
PubMed ID
31476893 View in PubMed
Less detail

Brain natriuretic peptide and cardiac resynchronization therapy in patients with mildly symptomatic heart failure.

https://arctichealth.org/en/permalink/ahliterature112755
Source
Circ Heart Fail. 2013 Sep 1;6(5):998-1004
Publication Type
Article
Date
Sep-1-2013
Author
Andrew Brenyo
Alon Barsheshet
Mohan Rao
David T Huang
Wojciech Zareba
Scott McNitt
W Jackson Hall
Derick R Peterson
Scott D Solomon
Arthur J Moss
Ilan Goldenberg
Author Affiliation
Division of Cardiology, and the Department of Biostatistics, University of Rochester Medical Center, Rochester, NY; and the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.
Source
Circ Heart Fail. 2013 Sep 1;6(5):998-1004
Date
Sep-1-2013
Language
English
Publication Type
Article
Keywords
Aged
Biological Markers - blood
Canada
Cardiac Resynchronization Therapy - adverse effects - mortality
Cardiac Resynchronization Therapy Devices
Chi-Square Distribution
Defibrillators, Implantable
Electric Countershock - adverse effects - instrumentation - mortality
Europe
Female
Heart Failure - blood - diagnosis - mortality - therapy
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Multicenter Studies as Topic
Multivariate Analysis
Natriuretic Peptide, Brain - blood
Proportional Hazards Models
Randomized Controlled Trials as Topic
Retrospective Studies
Risk factors
Severity of Illness Index
Time Factors
Treatment Outcome
United States
Up-Regulation
Abstract
There are limited data on the prognostic implications of brain natriuretic peptide (BNP) assessment in patients with mildly symptomatic heart failure (HF) who receive cardiac resynchronization therapy with a defibrillator (CRT-D).
The effect of elevated baseline and 1-year BNP levels (dichotomized at the upper tertile BNP of 120 pg/mL) on the risk of HF or death was assessed among the cohort of 1197 patients with baseline BNP data enrolled in MADIT (Multicenter Automated Defibrillator Implantation Trial)-CRT. Elevated baseline BNP was associated with a significant 68% (P=0.007) and 58% (P=0.02) increase in the risk of HF or death among MADIT-CRT patients allocated to CRT-D and implantable cardioverter defibrillator-only therapy, respectively. At 1 year of follow-up, patients allocated to CRT-D displayed significantly greater reductions in BNP (26% reduction) levels compared with implantable cardioverter defibrillator-only patients (8% increase; P=0.005). Patients with CRT-D in whom 1-year BNP levels were reduced or remained low experienced a significantly lower risk of subsequent HF or death as compared with patients in whom 1-year BNP levels were high. Similarly, the echocardiographic response to CRT-D was highest among those who maintained low BNP levels or in whom BNP level at 1-year was reduced.
Our findings suggest that assessment of baseline and follow-up BNP provides important prognostic implications in patients with mildly symptomatic HF who receive CRT.
PubMed ID
23801020 View in PubMed
Less detail

Cardiac resynchronization therapy in patients with permanent atrial fibrillation: results from the Resynchronization for Ambulatory Heart Failure Trial (RAFT).

https://arctichealth.org/en/permalink/ahliterature121574
Source
Circ Heart Fail. 2012 Sep 1;5(5):566-70
Publication Type
Article
Date
Sep-1-2012
Author
Jeff S Healey
Stefan H Hohnloser
Derek V Exner
David H Birnie
Ratika Parkash
Stuart J Connolly
Andrew D Krahn
Chris S Simpson
Bernard Thibault
Magdy Basta
Francois Philippon
Paul Dorian
Girish M Nair
Soori Sivakumaran
Elizabeth Yetisir
George A Wells
Anthony S L Tang
Author Affiliation
Population Health Research Institute, Hamilton, Ontario, Canada.
Source
Circ Heart Fail. 2012 Sep 1;5(5):566-70
Date
Sep-1-2012
Language
English
Publication Type
Article
Keywords
Action Potentials
Aged
Atrial Fibrillation - complications - diagnosis - mortality - physiopathology
Canada
Cardiac Resynchronization Therapy - adverse effects - mortality
Cardiac Resynchronization Therapy Devices
Defibrillators, Implantable
Electric Countershock - adverse effects - instrumentation - mortality
Exercise Test
Female
Heart Failure - complications - diagnosis - mortality - physiopathology - therapy
Hospitalization
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Proportional Hazards Models
Questionnaires
Stroke Volume
Time Factors
Treatment Outcome
Ventricular Function, Left
Abstract
Cardiac resynchronization (CRT) prolongs survival in patients with systolic heart failure and QRS prolongation. However, most trials excluded patients with permanent atrial fibrillation.
The Resynchronization for Ambulatory Heart Failure Trial (RAFT) randomized patients to an implantable cardioverter defibrillator (ICD) or ICD+CRT, stratified by the presence of permanent atrial fibrillation. Patients with permanent atrial fibrillation were randomized to CRT-ICD (n=114) or ICD (n=115). Patients receiving a CRT-ICD were similar to those receiving an ICD: age (71.6±7.3 versus 70.4±7.7 years), left ventricular ejection fraction (22.9±5.3% versus 22.3±5.1%), and QRS duration (151.0±23.6 versus 153.4±24.7 ms). There was no difference in the primary outcome of death or heart failure hospitalization between those assigned to CRT-ICD versus ICD (hazard ratio, 0.96; 95% CI, 0.65-1.41; P=0.82). Cardiovascular death was similar between treatment arms (hazard ratio, 0.97; 95% CI, 0.55-1.71; P=0.91); however, there was a trend for fewer heart failure hospitalizations with CRT-ICD (hazard ratio, 0.58; 95% CI, 0.38-1.01; P=0.052). The change in 6-minute hall walk duration between baseline and 12 months was not different between treatment arms (CRT-ICD: 19±84 m versus ICD: 16±76 m; P=0.88). Patients treated with CRT-ICD showed a trend for a greater improvement in Minnesota Living with Heart Failure score between baseline and 6 months (CRT-ICD: 41±21 to 31±21; ICD: 33±20 to 28±20; P=0.057).
Patients with permanent atrial fibrillation who are otherwise CRT candidates appear to gain minimal benefit from CRT-ICD compared with a standard ICD.
Notes
Comment In: Circ Heart Fail. 2013 Mar;6(2):e2223513051
Comment In: Circ Heart Fail. 2012 Sep 1;5(5):547-922991403
PubMed ID
22896584 View in PubMed
Less detail

Detection of high incidence of Riata lead breaches by systematic postero-anterior and lateral chest X-ray in a large cohort.

https://arctichealth.org/en/permalink/ahliterature119267
Source
Europace. 2013 Mar;15(3):402-8
Publication Type
Article
Date
Mar-2013
Author
Christian Steinberg
Jean-François Sarrazin
François Philippon
Marc-André Bouchard
Gilles O'Hara
Franck Molin
Isabelle Nault
Louis Blier
Jean Champagne
Author Affiliation
Division of Electrophysiology, Quebec Heart and Lung Institute, Affiliated to Laval University, 2725, Chemin Sainte-Foy, Quebec G1V 4G5, Canada.
Source
Europace. 2013 Mar;15(3):402-8
Date
Mar-2013
Language
English
Publication Type
Article
Keywords
Cohort Studies
Defibrillators, Implantable
Electric Countershock - adverse effects - instrumentation - mortality
Humans
Incidence
Logistic Models
Multivariate Analysis
Predictive value of tests
Prosthesis Design
Prosthesis Failure
Quebec
Radiography, Thoracic
Abstract
Insulation breaches with externalization of conductor cables have been described for St-Jude Medical Riataâ„¢ defibrillation leads. Published data on the incidence of Riata lead abnormalities are quite heterogeneous. The objective of this study was to estimate systematically the prevalence of lead abnormalities using a postero-anterior (PA) and lateral chest X-ray (CXR).
From 2002 to 2008, 552 Riata defibrillation leads were implanted at our centre. We evaluated patients for potential insulation breaches. A PA and lateral CXR was obtained. Chest X-rays were reviewed by two electrophysiologists using a zooming function with magnification up to factor 7.5 and were classified as normal or abnormal for the presence of conductor externalization. A total of 284 patients were included. Riata lead models were 1570, 1580, 1582, 1590, 1592, 7000, 7002, and 7022. The total frequency of radiological lead defects was 24.3%. Insulation breaches occurred at zones of major lead curvature. Mean maximal spacing between extruding lead components was 3.6 ± 1.9 mm (range 2.0-12.4). Abnormal CXRs were more frequent in 8F leads (31.4% vs. 6.3%; P
PubMed ID
23118004 View in PubMed
Less detail

Dispatch of Firefighters and Police Officers in Out-of-Hospital Cardiac Arrest: A Nationwide Prospective Cohort Trial Using Propensity Score Analysis.

https://arctichealth.org/en/permalink/ahliterature292220
Source
J Am Heart Assoc. 2017 Oct 04; 6(10):
Publication Type
Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Date
Oct-04-2017
Author
Ingela Hasselqvist-Ax
Per Nordberg
Johan Herlitz
Leif Svensson
Martin Jonsson
Jonny Lindqvist
Mattias Ringh
Andreas Claesson
Johan Björklund
Jan-Otto Andersson
Caroline Ericson
Pär Lindblad
Lars Engerström
Mårten Rosenqvist
Jacob Hollenberg
Author Affiliation
Department of Medicine, Center for Resuscitation Science, Karolinska Institutet, Solna, Sweden.
Source
J Am Heart Assoc. 2017 Oct 04; 6(10):
Date
Oct-04-2017
Language
English
Publication Type
Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Keywords
Cardiopulmonary Resuscitation - adverse effects - mortality
Defibrillators
Electric Countershock - adverse effects - instrumentation - mortality
Emergency Medical Dispatch
Emergency medical services
Firefighters
Hospital Mortality
Humans
Kaplan-Meier Estimate
Logistic Models
Odds Ratio
Out-of-Hospital Cardiac Arrest - diagnosis - mortality - therapy
Police
Process Assessment (Health Care)
Propensity Score
Prospective Studies
Risk factors
Sweden
Time Factors
Treatment Outcome
Abstract
Dispatch of basic life support-trained first responders equipped with automated external defibrillators in addition to advanced life support-trained emergency medical services personnel in out-of-hospital cardiac arrest (OHCA) has, in some minor cohort studies, been associated with improved survival. The aim of this study was to evaluate the association between basic life support plus advanced life support response and survival in OHCA at a national level.
This prospective cohort study was conducted from January 1, 2012, to December 31, 2014. People who experienced OHCA in 9 Swedish counties covered by basic life support plus advanced life support response were compared with a propensity-matched contemporary control group of people who experienced OHCA in 12 counties where only emergency medical services was dispatched, providing advanced life support. Primary outcome was survival to 30 days. The analytic sample consisted of 2786 pairs (n=5572) derived from the total cohort of 7308 complete cases. The median time from emergency call to arrival of emergency medical services or first responder was 9 minutes in the intervention group versus 10 minutes in the controls (P
Notes
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PubMed ID
28978527 View in PubMed
Less detail

Higher survival rates in exercise-related out-of-hospital cardiac arrests, compared to non-exercise-related - a study from the Swedish Register of Cardiopulmonary Resuscitation.

https://arctichealth.org/en/permalink/ahliterature294728
Source
Eur J Prev Cardiol. 2017 10; 24(15):1673-1679
Publication Type
Comparative Study
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Date
10-2017
Author
Matilda F Torell
Anneli Strömsöe
Ellen Zagerholm
Johan Herlitz
Andreas Claesson
Leif Svensson
Mats Börjesson
Author Affiliation
1 Sahlgrenska Academy, Sweden.
Source
Eur J Prev Cardiol. 2017 10; 24(15):1673-1679
Date
10-2017
Language
English
Publication Type
Comparative Study
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Cardiopulmonary Resuscitation - adverse effects - instrumentation - mortality
Defibrillators
Electric Countershock - adverse effects - instrumentation - mortality
Exercise
Female
Humans
Incidence
Male
Middle Aged
Out-of-Hospital Cardiac Arrest - diagnosis - mortality - physiopathology - therapy
Registries
Retrospective Studies
Risk factors
Sweden - epidemiology
Time Factors
Treatment Outcome
Abstract
Background Despite the positive effects of physical activity, the risk of sudden cardiac arrest is transiently increased during and immediately after exercise. The purpose of this study was to assess the incidence of exercise-related out-of-hospital cardiac arrest in the general population and to compare characteristics and prognosis of these cardiac arrests with non-exercise-related out-of-hospital cardiac arrests. Methods Data from all cases of treated out-of-hospital cardiac arrest outside of home reported to the Swedish Register of Cardiopulmonary Resuscitation from 2011-2015 in three counties of Sweden were investigated (population 2.1?m). This registry captures almost 100% of all out-of-hospital cardiac arrests in Sweden. Results Of 1825 out-of hospital cardiac arrests, 137 (7.5%) were exercise-related, resulting in an incidence of 1.2 per 100,000 person-years. The 30-day survival rate was significantly higher among exercise-related out-of hospital cardiac arrests compared to non-exercise-related out-of-hospital cardiac arrests (54.3 % vs 19.4%, p?
PubMed ID
28870144 View in PubMed
Less detail

Predictors of short-term complications after implantable cardioverter-defibrillator replacement: results from the Ontario ICD Database.

https://arctichealth.org/en/permalink/ahliterature136980
Source
Circ Arrhythm Electrophysiol. 2011 Apr;4(2):136-42
Publication Type
Article
Date
Apr-2011
Author
Andrew D Krahn
Douglas S Lee
David Birnie
Jeffrey S Healey
Eugene Crystal
Paul Dorian
Christopher S Simpson
Yaariv Khaykin
Douglas Cameron
Amir Janmohamed
Raymond Yee
Peter C Austin
Zhongliang Chen
Judy Hardy
Jack V Tu
Author Affiliation
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada. akrahn@uwo.ca
Source
Circ Arrhythm Electrophysiol. 2011 Apr;4(2):136-42
Date
Apr-2011
Language
English
Publication Type
Article
Keywords
Aged
Cause of Death
Chi-Square Distribution
Databases as Topic
Defibrillators, Implantable - adverse effects
Device Removal
Electric Countershock - adverse effects - instrumentation - mortality
Equipment Failure
Female
Humans
Male
Middle Aged
Ontario
Proportional Hazards Models
Prospective Studies
Registries
Risk assessment
Risk factors
Time Factors
Treatment Outcome
Abstract
Complications after implantable cardioverter-defibrillator (ICD) replacement are often clinically devastating, particularly when infection or reoperation occurs. Identifying factors contributing to complications may permit identification of high-risk individuals that warrant incremental monitoring and therapy to attenuate risk. In addition, replacement may be a discretionary decision in the context of an advisory or borderline device performance and patient, device, and implanter factors that predict adverse outcome may assist in clinical decision-making.
In a prospective, multicenter, population-based registry of all ICD patients at 18 centers in Ontario, Canada, we examined 45-day complication and all-cause mortality rates from February 2007 to August 2009 in patients undergoing ICD generator replacement. Complications were determined longitudinally and were categorized as major or minor. ICD replacement was performed in 1081 of 5176 patients (20.8%) undergoing ICD implantation (age, 64.3±12.7 years; 78.5% men). In patients undergoing ICD replacement, 47 patients (4.3%) had a complication within 45 days, with 47 major complications in 28 patients (2.6%), most commonly infection (n=23), lead revision (n=35), electrical storm (n=14), and pulmonary edema (n=13). Minor complications occurred in 2.3% of patients, most commonly incisional infection (n=10) and pocket hematoma (n=10). On multivariable analysis, risk factors associated with major complications were Canadian Cardiovascular Society angina class (adjusted hazard ratio [HR], 3.70 for class 2 to 4 versus 0 to 1; P=0.027) and multiple previous procedures on the pocket (adjusted HR, 3.35 for >1 versus 1; P=0.058). Risk factors associated with any complication were the use of antiarrhythmic therapy (adjusted HR, 6.29; P=0.001), implanter volume (adjusted HR 10.4 for 120/y, P=0.026), and Canadian Cardiovascular Society angina class (adjusted HR, 3.00 for class 2 to 4 versus 0 to 1; P=0.031). In a Cox model with a time-dependent variable of major complication within 45 days after replacement, major complications after ICD replacement were associated with an increased risk of mortality at 45, 90, and 180 days (adjusted HR, 9.61, 12.69, and 6.41, respectively; P=0.002 to 0.039).
Risk factors associated with complications after ICD replacement include the presence of angina, antiarrhythmic therapy, increased number of previous procedures, and low implanter volume. Major complications may be associated with increased risk of subsequent mortality.
PubMed ID
21325209 View in PubMed
Less detail

Shared Decision-Making About End-of-Life Care Scenarios Compared Among Implantable Cardioverter Defibrillator Patients: A National Cohort Study.

https://arctichealth.org/en/permalink/ahliterature308687
Source
Circ Heart Fail. 2019 10; 12(10):e005619
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
10-2019
Author
Jessica Harman Thompson
Ingela Thylén
Debra K Moser
Author Affiliation
College of Nursing, University of Kentucky, Lexington (J.H.T., D.K.M.).
Source
Circ Heart Fail. 2019 10; 12(10):e005619
Date
10-2019
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Aged
Choice Behavior
Clinical Decision-Making
Cross-Sectional Studies
Decision Making, Shared
Defibrillators, Implantable
Electric Countershock - adverse effects - instrumentation - mortality
Female
Health Knowledge, Attitudes, Practice
Heart Failure - mortality - physiopathology - psychology - therapy
Humans
Male
Middle Aged
Patient Participation
Physician-Patient Relations
Quality of Life
Registries
Surveys and Questionnaires
Sweden
Terminal Care
Abstract
Authors of expert guidelines and consensus statements recommend that decisions at the end-of-life (EOL) be discussed before and after implantation of an implantable cardioverter defibrillator (ICD) and include promotion of shared decision-making. The purpose of this study was to describe experiences, attitudes, and knowledge about the ICD at EOL in ICD recipients and to compare experiences, attitudes, and knowledge in ICD recipients with and without heart failure (HF). We further sought to determine factors associated with having discussions about EOL.
Using a national registry in Sweden of all ICD recipients (n=5355) in 2012, an EOL questionnaire, along with other ICD-related measures, was completed by 2403 ICD recipients. Of the participants, 1275 (n=53%) had HF. Their responses in the knowledge, experience, and attitude domains were almost identical to those without HF. Forty percent of patients with and without HF did not want to discuss their illness trajectory or deactivation of their ICD ever. In logistic regression analyses, we found that having had an ICD shock (OR, 2.05; CI, 1.64-2.56), having high levels of anxiety (OR, 1.41; CI, 1.04-1.92), and having high levels of ICD concerns (OR, 1.53; CI, 1.22-1.92) were the only significant predictors of having discussions with providers about EOL scenarios (P
Notes
CommentIn: Circ Heart Fail. 2019 Oct;12(10):e006289 PMID 31601114
PubMed ID
31601115 View in PubMed
Less detail

Use of primary prevention implantable cardioverter-defibrillators in a population-based cohort is associated with a significant survival benefit.

https://arctichealth.org/en/permalink/ahliterature123590
Source
Circ Arrhythm Electrophysiol. 2012 Aug 1;5(4):706-13
Publication Type
Article
Date
Aug-1-2012
Author
Ratika Parkash
John L Sapp
Magdy Basta
Steve Doucette
Kara Thompson
Martin Gardner
Chris Gray
Brenda Brownell
Hena Kidwai
Jafna Cox
Author Affiliation
Department of Medicine, Queen Elizabeth II Health Sciences Center and the Department of Community Health and Epidemiology, Research Methods Unit, Dalhousie University, Halifax, Nova Scotia, Canada. parkashr@cdha.nshealth.ca
Source
Circ Arrhythm Electrophysiol. 2012 Aug 1;5(4):706-13
Date
Aug-1-2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Chi-Square Distribution
Death, Sudden, Cardiac - etiology - prevention & control
Defibrillators, Implantable
Electric Countershock - adverse effects - instrumentation - mortality
Female
Humans
Kaplan-Meier Estimate
Logistic Models
Male
Middle Aged
Multivariate Analysis
Nova Scotia
Patient Selection
Primary prevention - methods
Propensity Score
Referral and Consultation
Registries
Retrospective Studies
Risk assessment
Risk factors
Time Factors
Treatment Outcome
Abstract
Underuse of implantable defibrillators has been previously noted in patients at risk for sudden cardiac death, as well as for survivors of sudden cardiac death. We sought to determine the utilization rates in a primary prevention implantable cardioverter-defibrillator (ICD)-eligible population and mortality in this group compared with a group that had undergone implantation of this therapy.
A retrospective cohort of patients from April 1, 2006, to December 31, 2009, was used to define a primary prevention ICD-eligible population. Two groups were compared on the basis of ICD implantation (no-ICD versus ICD). The primary outcome measure was mortality. Of the 717 patients found to be potentially eligible for a primary prevention ICD, 116 (16%) were referred. The remaining cohort of 601 patients were compared with an existing cohort of primary prevention ICD patients (n=290). A significant survival benefit was associated with primary prevention ICD implantation (hazard ratio, 0.46; 95% CI [0.33-0.64]; P
Notes
Comment In: Circ Arrhythm Electrophysiol. 2012 Aug 1;5(4):624-522895600
PubMed ID
22685111 View in PubMed
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9 records – page 1 of 1.