Arrhythmias & electrophysiologyCohort study
Evolution of primary prevention implantable cardioverter-defibrillator clinical utility across therapeutic eras in ischemic and nonischemic cardiomyopathy
- single-center retrospective study
- tertiary care hospital
Authors' conclusion
The decline in clinical utility of PP ICDs in both ICM and NICM warrants updated evidence to guide ICD use in contemporary practice.
Study context
- Population
- Patients with ischemic (ICM) or nonischemic cardiomyopathy (NICM) and a primary prevention (PP) implantable cardioverter-defibrillator (ICD) indication who received an ICD20.4% women, median age of 64 years, 44.7% cardiac resynchronization therapy
- Participants
- 1,050 patients
- Exposure
- Appropriate ICD interventions, ICDRM, and all-cause mortality across 3 therapeutic eras, in the overall population and in patients with ICM or NICM exclusively
Main finding
As reported in the abstract
Appropriate shock incidence, ICM and NICM
Significant decline in appropriate shock incidence across eras for both ICM and NICM
P < .001
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| ICDRM incidence, ICM | era 1 3.7%/y · share of all mortality 50.0% · era 3 5.6%/y · share of all mortality 88.9% |
| ICDRM incidence, NICM | era 1 1.2%/y · share of all mortality 26.1% · era 3 3.2%/y · share of all mortality 97.0% |
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Evolution of primary prevention implantable cardioverter-defibrillator clinical utility across therapeutic eras in ischemic and nonischemic cardiomyopathy. Heart Rhythm. Published 9 October 2025. doi:10.1016/j.hrthm.2025.10.008
Summarised from the published abstract; every number is checked against it