Heart failure & cardiomyopathiesCohort study
Etiology-dependent prognostic impact of atrial fibrillation in implantable cardioverter-defibrillator and cardiac resynchronization therapy recipients
- nationwide cardiac device registry
- Multivariable Cox and Fine-Gray competing risk models
- Propensity score matching was performed within ischemic cardiomyopathy (ICM) and non-ICM (NICM) subgroups
Authors' conclusion
The prognostic impact of AF among ICD/CRT recipients differs markedly by cardiomyopathy etiology. AF identifies a high-risk subgroup within NICM, whereas its effect is attenuated in ICM. Etiology-specific risk assessment should be incorporated into clinical management.
Study context
- Population
- Implantable cardioverter-defibrillators (ICD)/cardiac resynchronization therapy (CRT) patientspatients in a nationwide cardiac device registry
- Participants
- 4,623 patients
- Exposure
- whether the prognostic impact of atrial fibrillation (AF) differs between NICM and ICM in ICD/CRT patients
Main finding
As reported in the abstract
Mortality, cardiac death, and heart failure hospitalization in NICM
- AF was associated with higher risks of mortality, cardiac death, and heart failure hospitalization in NICM across all models
Observational data: associations, not effects.
Further findings
Mortality in ICM
- the association between AF and mortality in ICM was attenuated and no longer statistically significant after multivariable adjustment
Mortality after propensity score matching
- AF remained associated with increased mortality in NICM but not in ICM
- propensity score matching
ICD therapies
- AF impact on rates of ICD therapies did not differ between etiologies
Original publication
Etiology-dependent prognostic impact of atrial fibrillation in implantable cardioverter-defibrillator and cardiac resynchronization therapy recipients. Heart Rhythm. Published 2 July 2026. doi:10.1016/j.hrthm.2026.06.039
Summarised from the published abstract; every number is checked against it