Arrhythmias & electrophysiology
Late-gadolinium enhancement predicts appropriate device therapies in nonischemic recipients of primary prevention implantable cardioverter-defibrillators
Main finding · Appropriate ICD therapiesResult — go to the resultHazard ratio 2.99 95% CI 1.48–6.02Authors' conclusion
In patients with NICM and primary prevention ICDs, LGE ≥2% is predictive of appropriate device therapies but not all-cause mortality/LVAD/transplant. LGE may be a relatively specific predictor of sudden cardiac arrest risk and therefore could potentially be used during evaluation for prophylactic ICD implantation.
Study context
- Population
- Patients with nonischemic cardiomyopathy (NICM) who underwent primary prevention ICD implantation at Cleveland Clinic between 2003 and 2021 with cardiac magnetic resonance (CMR) within 12 months before implantpatients with NICM and primary prevention implantable cardioverter-defibrillators (ICDs)
- Participants
- 344 patients
- Exposure
- Significant late gadolinium enhancement (LGE) vs none or minimal LGE on CMR
- Significant LGEn = 219
- None or minimal LGEn = 125reference
- Outcome
- Appropriate ICD therapies
- Follow-up
- Median 61 months
Methodological detailssingle-centre (Cleveland Clinic), endpoints adjudicated retrospectively by chart review
- Single-centre (Cleveland Clinic)
- Endpoints adjudicated retrospectively by chart review
Main finding
As reported in the abstract
Hazard ratio
2.99
95% CI 1.48–6.02
P = 0.002
Events by group
Significant LGEvs None or minimal LGE
HR 2.99 (95% CI 1.48–6.02); P = 0.002
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Significant LGE | None or minimal LGE | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| All-cause mortality/transplant/LVAD implantation (secondary endpoint) · median follow-up of 61 monthsMultivariable Cox regression | 26% | 17% | 1.34 (0.78–2.29) | P = 0.287 | |
| 0.512Hazard ratio (log scale) |
Original publication
Late-gadolinium enhancement predicts appropriate device therapies in nonischemic recipients of primary prevention implantable cardioverter-defibrillators. Heart Rhythm. Published 10 January 2025. doi:10.
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