Arrhythmias & electrophysiology
Contemporary Implantable Cardioverter-Defibrillator Benefit: Time to First Therapy in a Large, Real-World Cohort
Authors' conclusion
Nearly half of contemporary patients receive appropriate ICD therapy by 10 years postimplantation. These data indicate continued benefit of ICD therapy despite modern refinements to device management and medical and interventional cardiac care.
Study context
- Population
- First-time Medtronic single- or dual-chamber ICD recipients71.8% male
- Participants
- 237,627 participants
- Exposure
- Secondary prevention vs primary prevention ICD indication
- Outcome
- Time to first appropriate therapy (shock, ATP, or any therapy)
- Follow-up
- 10 years
Methodological detailsremote monitoring database (Medtronic CareLink), 2013–2024, adjudicated random subset of 595 episodes used to model appropriateness
- Remote monitoring database (Medtronic CareLink), 2013–2024
- Adjudicated random subset of 595 episodes used to model appropriateness
Main finding
As reported in the abstract
Cumulative incidence of first appropriate therapy
First appropriate shock
33%
First appropriate antitachycardia pacing (ATP)
42%
Any appropriate therapy
48%
Observational data: associations, not effects.
Further findings
Cumulative incidence of first appropriate therapy, by ICD indication · 10 years
Shock
ATP
Any appropriate therapy
Original publication
Contemporary Implantable Cardioverter-Defibrillator Benefit: Time to First Therapy in a Large, Real-World Cohort. JACC Clin Electrophysiol. Published 13 August 2025. doi:10.
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