Heart failure & cardiomyopathies
Atrial fibrillation and implantable cardioverter-defibrillator in non-ischaemic heart failure with reduced ejection fraction: insights from the DANISH trial
Authors' conclusion
In the DANISH trial, the presence of AF was associated with a greater effect of ICD implantation on cardiovascular death, and although similar trends were observed for all-cause and sudden cardiovascular death, the treatment-by-subgroup interaction was not statistically significant for these outcomes.
Study context
- Population
- Patients with non-ischaemic HFrEF randomised in DANISH, by atrial fibrillation (AF) at baseline (history and/or on enrollment ECG)418 (37.5%) with AF
- Participants
- 1,116 patients
- Comparison
- Primary prevention implantable cardioverter-defibrillator (ICD) vs usual clinical care, by AF status
- Primary endpoint
- All-cause death
Methodological detailssubgroup analysis by AF status
- Subgroup analysis by AF status
Primary result
As reported in the abstract
All-cause death, by AF status
ICD vs Usual clinical careHazard ratio (95% CI)
With AF
0.78(0.59–1.03)
Without AF
0.98(0.75–1.27)
Secondary outcomes
| Outcome | HR (95% CI) | |
|---|---|---|
| CV death, by AF statusICDvs Usual clinical careWith AF | 0.67 (0.48–0.94) | |
| CV death, by AF statusICDvs Usual clinical careWithout AF | 1.04 (0.76–1.41) | |
| Sudden CV death, by AF statusICDvs Usual clinical careWith AF | 0.45 (0.24–0.82) | |
| Sudden CV death, by AF statusICDvs Usual clinical careWithout AF | 0.76 (0.41–1.38) | |
| 0.20.5125Hazard ratio (log scale) |
- CV death, by AF status: interaction P = 0.04
- Sudden CV death, by AF status: interaction P = 0.20
Original publication
Atrial fibrillation and implantable cardioverter-defibrillator in non-ischaemic heart failure with reduced ejection fraction: insights from the DANISH trial. Europace. Published 24 September 2025. doi:10.
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