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Europace. 2017 Apr 1;19(4):660-664. doi: 10.1093/europace/eux089.

Implantable cardioverter defibrillator use for primary prevention in ischaemic and non-ischaemic heart disease-indications in the post-DANISH trial era: results of the European Heart Rhythm Association survey.

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Department of Cardiology, Center for Cardiological Innovation, Institute for Surgical Research, Oslo University Hospital, Rikshospitalet, Sognsvannsveien 20, 0372 Oslo, Norway.
Insitute of Clinical Medicine, University of Oslo, PO Box 4950, Nydalen, 0424 Oslo, Norway.
Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine), University Heart Center L├╝beck, University Hospital Schleswig-Holstein, Germany.
Department of Cardiology, Cardiac Arrhythmias Management Department, Clinique Pasteur, Toulouse, France.
Cardiology Clinic, Emergency Institute for Cardiovascular Diseases and Transplant, University of Medicine and Pharmacy, Tirgu Mures, Romania.
Department of Cardiology, Institution of Medical Science, Uppsala University, Sweden.
University Hospital of Brest and EA 4324 ORPHY UBO, Brest, France.
Jo Ann Medical Centre-Tbilisi, 21 Ljubljana St, Tbilisi, Georgia.
Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany.


Implantable cardioverter-defibrillator (ICD) is the standard of care for prevention of sudden cardiac death (SCD) in high-risk patients. For primary prevention of SCD, in patients with ischaemic heart disease, there is more robust data on the effect of ICD therapy compared with patients with non-ischaemic heart disease, but current real-life practice may differ substantially. The aim of this European Heart Rhythm Association survey was to evaluate the clinical practice regarding implantation of ICD for primary prevention among European countries in patients with non-ischaemic and ischaemic heart disease. Furthermore, we wanted to investigate the impact of the results of the recently published DANISH trial on clinical practice among European countries. In total, 48 centres from 17 different countries responded to the questionnaire. The majority did not implant ICD for primary prevention on a regular basis in patients with non-ischaemic heart disease despite current guidelines. Also, centres have changed their indications after the recent report on the efficacy of ICD in these patients. In patients with ischaemic heart disease, the guidelines for primary prevention ICD were followed on a regular basis, and no relevant change in indications were reported.


Cardiac resynchronization therapy; EHRA survey; EP wire; Heart failure; Implantable cardioverter-defibrillator; Ischemic cardiomyopathy; Ischemic heart disease; Non-ischemic cardiomyopathy; Pacing; Prevention; Sudden cardiac death; Ventricular arrhythmias

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