Present criteria for prophylactic ICD implantation: Insights from the EU-CERT-ICD (Comparative Effectiveness Research to Assess the Use of Primary ProphylacTic Implantable Card

09/12/2019
by   M. Zabel, et al.
0

BACKGROUND. The clinical effectiveness of primary prevention implantable cardioverter defibrillator (ICD) therapy is under debate. It is urgently needed to better identify patients who benefit from prophylactic ICD therapy. The EUropean Comparative Effectiveness Research to Assess the Use of Primary ProphylacTic Implantable Cardioverter Defibrillators (EU-CERT-ICD) completed in 2019 will assess this issue. SUMMARY. The EU-CERT-ICD is a prospective investigator-initiated non-randomized, controlled, multicenter observational cohort study done in 44 centers across 15 European countries. A total of 2327 patients with heart failure due to ischemic heart disease or dilated cardiomyopathy indicated for primary prophylactic ICD implantation were recruited between 2014 and 2018 (>1500 patients at first ICD implantation, >750 patients non-randomized non-ICD control group). The primary endpoint was all-cause mortality, first appropriate shock was co-primary endpoint. At baseline, all patients underwent 12-lead ECG and Holter-ECG analysis using multiple advanced methods for risk stratification as well as documentation of clinical characteristics and laboratory values. The EU-CERT-ICD data will provide much needed information on the survival benefit of preventive ICD therapy and expand on previous prospective risk stratification studies which showed very good applicability of clinical parameters and advanced risk stratifiers in order to define patient subgroups with above or below average ICD benefit. CONCLUSION. The EU-CERT-ICD study will provide new and current data about effectiveness of primary prophylactic ICD implantation. The study also aims for improved risk stratification and patient selection using clinical risk markers in general, and advanced ECG risk markers in particular.

READ FULL TEXT

page 1

page 17

page 23

research
05/11/2022

Machine Learning to Support Triage of Children at Risk for Epileptic Seizures in the Pediatric Intensive Care Unit

Objective: Epileptic seizures are relatively common in critically-ill ch...
research
08/22/2022

Atrial Fibrillation Recurrence Risk Prediction from 12-lead ECG Recorded Pre- and Post-Ablation Procedure

Introduction: 12-lead electrocardiogram (ECG) is recorded during atrial ...
research
06/09/2023

ElectroCardioGuard: Preventing Patient Misidentification in Electrocardiogram Databases through Neural Networks

Electrocardiograms (ECGs) are commonly used by cardiologists to detect h...
research
11/03/2021

Cross-validated risk scores adaptive enrichment (CADEN) design

We propose a Cross-validated ADaptive ENrichment design (CADEN) in which...
research
06/11/2023

CARNA: Characterizing Advanced heart failure Risk and hemodyNAmic phenotypes using learned multi-valued decision diagrams

Early identification of high risk heart failure (HF) patients is key to ...
research
09/13/2023

In Silico Fatigue Optimization of TAVR Stent Designs with Physiological Motion in a Beating Heart Model

The rapid expansion of TAVR to younger, low-risk patients raises concern...
research
03/10/2021

Deep learning methods for screening patients' S-ICD implantation eligibility

Subcutaneous Implantable Cardioverter-Defibrillators (S-ICDs) are used f...

Please sign up or login with your details

Forgot password? Click here to reset