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Should Primary Prevention ICDs Still Be Placed in Patients with Non-ischemic Cardiomyopathy? A Review of the Evidence

  • Invasive Electrophysiology and Pacing (EK Heist, Section Editor)
  • Published:
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Abstract

Purpose of Review

Recent evidence has suggested that implantable defibrillator (ICD) in non-ischemic cardiomyopathy (NICM) may not offer mortality benefit in the presence of guideline-directed medical therapy (GDMT) and cardiac resynchronization therapy (CRT).

Recent Findings

Despite significant benefits of GDMT and CRT, current evidence is derived from ICD trials that rely predominantly on reduced left ventricular ejection fraction alone (LVEF). The majority of patients with sudden cardiac death (SCD) have LVEF > 30% indicating that LVEF by itself is an inadequate predictor of SCD. The Danish study to assess the efficacy of ICD in patients with non-ischemic systolic heart failure on mortality (DANISH) highlights the importance of better risk stratifying NICM patients for ICD implantation.

Summary

Assessment of life expectancy, comorbidities, presence of advanced heart failure, etiology of NICM, and the presence of myocardial fibrosis can help risk stratify ICD beyond LVEF. Genetics and biomarkers can be of further assistance in risk stratification.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Klein HU, Inama G. Implantable defibrillators: 30 years of history. G Ital Cardiol (Rome). 2010;11(10 Suppl 1):48S–52S.

    Google Scholar 

  2. Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EN, Hafley G. A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators. N Engl J Med. 1999;341(25):1882–90. https://doi.org/10.1056/NEJM199912163412503.

    Article  CAS  PubMed  Google Scholar 

  3. Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS, et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002;346(12):877–83. https://doi.org/10.1056/NEJMoa013474.

    Article  PubMed  Google Scholar 

  4. Bansch D, Antz M, Boczor S, Volkmer M, Tebbenjohanns J, Seidl K, et al. Primary prevention of sudden cardiac death in idiopathic dilated cardiomyopathy: the Cardiomyopathy Trial (CAT). Circulation. 2002;105(12):1453–8.

    Article  PubMed  Google Scholar 

  5. Kadish A, Dyer A, Daubert JP, Quigg R, Estes NA, Anderson KP, et al. Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. N Engl J Med. 2004;350(21):2151–8. https://doi.org/10.1056/NEJMoa033088.

    Article  CAS  PubMed  Google Scholar 

  6. Kober L, Thune JJ, Nielsen JC, Haarbo J, Videbaek L, Korup E, et al. Defibrillator implantation in patients with nonischemic systolic heart failure. N Engl J Med. 2016;375(13):1221–30. https://doi.org/10.1056/NEJMoa1608029.

    Article  PubMed  Google Scholar 

  7. Berger RE, Ellenbogen KA, Stevenson WG. Implantable cardioverter-defibrillators in nonischemic cardiomyopathy. N Engl J Med. 2016;375(23):2290–2. https://doi.org/10.1056/NEJMclde1611988.

    Article  PubMed  Google Scholar 

  8. Bardy GH, Lee KL, Mark DB, Poole JE, Packer DL, Boineau R, et al. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med. 2005;352(3):225–37. https://doi.org/10.1056/NEJMoa043399.

    Article  CAS  PubMed  Google Scholar 

  9. Yancy CW, Jessup M, Bozkurt B, Butler J, Casey DE, Jr., Drazner MH et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 2013;62(16):e147–e239. doi:https://doi.org/10.1016/j.jacc.2013.05.019.

  10. Ponikowski P, Voors AA, Anker SD, Bueno H, Cleland JG, Coats AJ, et al. 2016 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Rev Esp Cardiol (Engl Ed). 2016;69(12):1167. https://doi.org/10.1016/j.rec.2016.11.005.

    Article  Google Scholar 

  11. Strickberger SA, Hummel JD, Bartlett TG, Frumin HI, Schuger CD, Beau SL, et al. Amiodarone versus implantable cardioverter-defibrillator: randomized trial in patients with nonischemic dilated cardiomyopathy and asymptomatic nonsustained ventricular tachycardia—AMIOVIRT. J Am Coll Cardiol. 2003;41(10):1707–12.

    Article  PubMed  Google Scholar 

  12. Bristow MR, Saxon LA, Boehmer J, Krueger S, Kass DA, De Marco T, et al. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med. 2004;350(21):2140–50. https://doi.org/10.1056/NEJMoa032423.

    Article  CAS  PubMed  Google Scholar 

  13. Lam SK, Owen A. Combined resynchronisation and implantable defibrillator therapy in left ventricular dysfunction: Bayesian network meta-analysis of randomised controlled trials. BMJ. 2007;335(7626):925. https://doi.org/10.1136/bmj.39343.511389.BE.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Colquitt JL, Mendes D, Clegg AJ, Harris P, Cooper K, Picot J, et al. Implantable cardioverter defibrillators for the treatment of arrhythmias and cardiac resynchronisation therapy for the treatment of heart failure: systematic review and economic evaluation. Health Technol Assess. 2014;18(56):1–560. https://doi.org/10.3310/hta18560.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Desai AS, Fang JC, Maisel WH, Baughman KL. Implantable defibrillators for the prevention of mortality in patients with nonischemic cardiomyopathy: a meta-analysis of randomized controlled trials. JAMA. 2004;292(23):2874–9. https://doi.org/10.1001/jama.292.23.2874.

    Article  CAS  PubMed  Google Scholar 

  16. • Al-Khatib SM, Fonarow GC, Joglar JA, Inoue LYT, Mark DB, Lee KL et al. Primary prevention implantable cardioverter defibrillators in patients with nonischemic cardiomyopathy: a meta-analysis. JAMA Cardiol. 2017;2(6):685-8. Doi:https://doi.org/10.1001/jamacardio.2017.0630. This meta-analysis demonstrates the benefit of ICD in NICM despite recent evidence from DANISH trial.

  17. Anantha Narayanan M, Vakil K, Reddy YN, Baskaran J, Deshmukh A, Benditt DG, et al. Efficacy of implantable cardioverter-defibrillator therapy in patients with nonischemic cardiomyopathy. A systematic review and meta-analysis of randomized controlled trials. 2017;3:962–70. https://doi.org/10.1016/j.jacep.2017.02.006.

  18. Golwala H, Bajaj NS, Arora G, Arora P. Implantable cardioverter-defibrillator for nonischemic cardiomyopathy: an updated meta-analysis. Circulation. 2017;135(2):201–3. https://doi.org/10.1161/CIRCULATIONAHA.116.026056.

    Article  PubMed  Google Scholar 

  19. Kolodziejczak M, Andreotti F, Kowalewski M, Buffon A, Ciccone MM, Parati G, et al. Implantable cardioverter-defibrillators for primary prevention in patients with ischemic or nonischemic cardiomyopathy: a systematic review and meta-analysis. Ann Intern Med. 2017;167(2):103–11. https://doi.org/10.7326/M17-0120.

    Article  PubMed  Google Scholar 

  20. Barakat AF, Saad M, Elgendy AY, Mentias A, Abuzaid A, Mahmoud AN, et al. Primary prevention implantable cardioverter defibrillator in patients with non-ischaemic cardiomyopathy: a meta-analysis of randomised controlled trials. BMJ Open. 2017;7(6):e016352. https://doi.org/10.1136/bmjopen-2017-016352.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Stavrakis S, Asad Z, Reynolds D. Implantable cardioverter defibrillators for primary prevention of mortality in patients with nonischemic cardiomyopathy: a meta-analysis of randomized controlled trials. J Cardiovasc Electrophysiol. 2017;28(6):659–65. https://doi.org/10.1111/jce.13204.

    Article  PubMed  Google Scholar 

  22. Romero J, Chaudhary R, Garg J, Lupercio F, Shah N, Gupta R, et al. Role of implantable cardioverter defibrillator in non-ischemic cardiomyopathy: a systematic review and meta-analysis of prospective randomized clinical trials. J Int Cardiac Electrophysiol : Int J Arrhythm Pacing. 2017;49(3):263–70. https://doi.org/10.1007/s10840-017-0260-8.

    Article  Google Scholar 

  23. Akel T, Lafferty J. Implantable cardioverter defibrillators for primary prevention in patients with nonischemic cardiomyopathy: a systematic review and meta-analysis. Cardiovasc Ther. 2017;35(3) https://doi.org/10.1111/1755-5922.12253.

  24. Masri A, Hammadah M, Adelstein E, Jain S, Saba S. Implantable cardioverter defibrillator in non-ischemic cardiomyopathy: a meta-analysis of randomized controlled trials. Cardiovasc Diagn Ther. 2017;7(4):397–404. https://doi.org/10.21037/cdt.2017.06.06.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Hindricks G, Dagres N, Camm AJ. ICD implantation in patients with nonischemic heart failure. N Engl J Med. 2017;376(1):89–92. https://doi.org/10.1056/NEJMc1614441.

    Article  PubMed  Google Scholar 

  26. Mathias A, Moss AJ, McNitt S, Zareba W, Goldenberg I, Solomon SD, et al. Clinical implications of complete left-sided reverse remodeling with cardiac resynchronization therapy: A MADIT-CRT Substudy. J Am Coll Cardiol. 2016;68(12):1268–76. https://doi.org/10.1016/j.jacc.2016.06.051.

    Article  PubMed  Google Scholar 

  27. Guglin MICD. Implantation in patients with nonischemic heart failure. N Engl J Med. 2017;376(1):91. https://doi.org/10.1056/NEJMc1614441#SA4.

    PubMed  Google Scholar 

  28. Leyva F, Zegard A, Acquaye E, Gubran C, Taylor R, Foley PWX, et al. Outcomes of cardiac resynchronization therapy with or without defibrillation in patients with nonischemic cardiomyopathy. J Am Coll Cardiol. 2017;70(10):1216–27. https://doi.org/10.1016/j.jacc.2017.07.712.

    Article  PubMed  Google Scholar 

  29. • Shen L, Jhund PS, Petrie MC, Claggett BL, Barlera S, Cleland JGF, et al. Declining risk of sudden death in heart failure. N Engl J Med. 2017;377(1):41–51. https://doi.org/10.1056/NEJMoa1609758. This study demonstrates the benefits of medical therapy in NICM.

    Article  PubMed  Google Scholar 

  30. Merlo M, Pyxaras SA, Pinamonti B, Barbati G, Di Lenarda A, Sinagra G. Prevalence and prognostic significance of left ventricular reverse remodeling in dilated cardiomyopathy receiving tailored medical treatment. J Am Coll Cardiol. 2011;57(13):1468–76. https://doi.org/10.1016/j.jacc.2010.11.030.

    Article  PubMed  Google Scholar 

  31. Gorgels AP, Gijsbers C, de Vreede-Swagemakers J, Lousberg A, Wellens HJ. Out-of-hospital cardiac arrest—the relevance of heart failure. The Maastricht Circulatory Arrest Registry. Eur Heart J. 2003;24(13):1204–9.

    Article  PubMed  Google Scholar 

  32. Stecker EC, Vickers C, Waltz J, Socoteanu C, John BT, Mariani R, et al. Population-based analysis of sudden cardiac death with and without left ventricular systolic dysfunction: two-year findings from the Oregon Sudden Unexpected Death Study. J Am Coll Cardiol. 2006;47(6):1161–6. https://doi.org/10.1016/j.jacc.2005.11.045.

    Article  PubMed  Google Scholar 

  33. Priori SG, Blomstrom-Lundqvist C. 2015 European Society of Cardiology Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac death summarized by co-chairs. Eur Heart J. 2015;36(41):2757–9. https://doi.org/10.1093/eurheartj/ehv445.

    Article  PubMed  Google Scholar 

  34. Goldberger JJ, Cain ME, Hohnloser SH, Kadish AH, Knight BP, Lauer MS, et al. American Heart Association/American College of Cardiology Foundation/heart Rhythm Society scientific statement on noninvasive risk stratification techniques for identifying patients at risk for sudden cardiac death: a scientific statement from the American Heart Association Council on Clinical Cardiology Committee on Electrocardiography and Arrhythmias and Council on Epidemiology and Prevention. Heart Rhythm. 2008;5(10):e1–21. https://doi.org/10.1016/j.hrthm.2008.05.031.

    Article  PubMed  Google Scholar 

  35. Fishman GI, Chugh SS, Dimarco JP, Albert CM, Anderson ME, Bonow RO, et al. Sudden cardiac death prediction and prevention: report from a National Heart, Lung, and Blood Institute and Heart Rhythm Society Workshop. Circulation. 2010;122(22):2335–48. https://doi.org/10.1161/CIRCULATIONAHA.110.976092.

    Article  PubMed  PubMed Central  Google Scholar 

  36. • Halliday BP, Gulati A, Ali A, Guha K, Newsome S, Arzanauskaite M, et al. Association between midwall late gadolinium enhancement and sudden cardiac death in patients with dilated cardiomyopathy and mild and moderate left ventricular systolic dysfunction. Circulation. 2017;135(22):2106–15. https://doi.org/10.1161/CIRCULATIONAHA.116.026910. This study demonstrates the significant impact of myocardial fibrosis on SCD in NICM.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Zipes DP, Camm AJ, Borggrefe M, Buxton AE, Chaitman B, Fromer M, et al. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (writing committee to develop Guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006;114(10):e385–484. https://doi.org/10.1161/CIRCULATIONAHA.106.178233.

    Article  PubMed  Google Scholar 

  38. Cleland JGF, Halliday BP, Prasad SK. Selecting patients with nonischemic dilated cardiomyopathy for ICDs. Myocardial Function, Fibrosis, and What’s Attached? 2017;70(10):1228–31. https://doi.org/10.1016/j.jacc.2017.07.748.

    Google Scholar 

  39. Hess PL, Al-Khatib SM, Han JY, Edwards R, Bardy GH, Bigger JT, et al. Survival benefit of the primary prevention implantable cardioverter-defibrillator among older patients: does age matter? An analysis of pooled data from 5 clinical trials. Circ Cardiovasc Qual Outcomes. 2015;8(2):179–86. https://doi.org/10.1161/CIRCOUTCOMES.114.001306.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Steinberg BA, Al-Khatib SM, Edwards R, Han J, Bardy GH, Bigger JT et al. Outcomes of implantable cardioverter-defibrillator use in patients with comorbidities: results from a combined analysis of 4 randomized clinical trials. JACC Heart Failure 2014;2(6):623–629. doi:https://doi.org/10.1016/j.jchf.2014.06.007.

  41. Halliday BP, Cleland JGF, Goldberger JJ, Prasad SK. Personalizing risk stratification for sudden death in dilated cardiomyopathy: the past, present, and future. Circulation. 2017;136(2):215–31. https://doi.org/10.1161/CIRCULATIONAHA.116.027134.

    Article  PubMed  Google Scholar 

  42. Kuruvilla S, Adenaw N, Katwal AB, Lipinski MJ, Kramer CM, Salerno M. Late gadolinium enhancement on cardiac magnetic resonance predicts adverse cardiovascular outcomes in nonischemic cardiomyopathy: a systematic review and meta-analysis. Circ Cardiovasc Imaging. 2014;7(2):250–8. https://doi.org/10.1161/CIRCIMAGING.113.001144.

    Article  PubMed  Google Scholar 

  43. Wu KC, Weiss RG, Thiemann DR, Kitagawa K, Schmidt A, Dalal D, et al. Late gadolinium enhancement by cardiovascular magnetic resonance heralds an adverse prognosis in nonischemic cardiomyopathy. J Am Coll Cardiol. 2008;51(25):2414–21. https://doi.org/10.1016/j.jacc.2008.03.018.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Gulati A, Jabbour A, Ismail TF, Guha K, Khwaja J, Raza S, et al. Association of fibrosis with mortality and sudden cardiac death in patients with nonischemic dilated cardiomyopathy. JAMA. 2013;309(9):896–908. https://doi.org/10.1001/jama.2013.1363.

    Article  CAS  PubMed  Google Scholar 

  45. Zipse MM, Tzou WS. Sudden cardiac death in nonischemic cardiomyopathy: refining risk assessment. J Cardiovasc Electrophysiol. 2017;28:1361–6. https://doi.org/10.1111/jce.13284.

    Article  PubMed  Google Scholar 

  46. Chan RH, Maron BJ, Olivotto I, Pencina MJ, Assenza GE, Haas T, et al. Prognostic value of quantitative contrast-enhanced cardiovascular magnetic resonance for the evaluation of sudden death risk in patients with hypertrophic cardiomyopathy. Circulation. 2014;130(6):484–95. https://doi.org/10.1161/CIRCULATIONAHA.113.007094.

    Article  PubMed  Google Scholar 

  47. Murtagh G, Laffin LJ, Beshai JF, Maffessanti F, Bonham CA, Patel AV, et al. Prognosis of myocardial damage in sarcoidosis patients with preserved left ventricular ejection fraction: risk stratification using cardiovascular magnetic resonance. Circ Cardiovasc Imaging. 2016;9(1):e003738. https://doi.org/10.1161/CIRCIMAGING.115.003738.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Memon S, Ganga HV, Kluger J. Late gadolinium enhancement in patients with nonischemic dilated cardiomyopathy. Pacing Clin Electrophysiol. 2016;39(7):731–47. https://doi.org/10.1111/pace.12873.

    Article  PubMed  Google Scholar 

  49. Bluemke DA. MRI of nonischemic cardiomyopathy. AJR Am J Roentgenol. 2010;195(4):935–40. https://doi.org/10.2214/AJR.10.4222.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Maron BJ, Towbin JA, Thiene G, Antzelevitch C, Corrado D, Arnett D, et al. Contemporary definitions and classification of the cardiomyopathies: an American Heart Association Scientific Statement from the Council on Clinical Cardiology, Heart Failure and Transplantation Committee; Quality of Care and Outcomes Research and Functional Genomics and Translational Biology Interdisciplinary Working Groups; and Council on Epidemiology and Prevention. Circulation. 2006;113(14):1807–16. https://doi.org/10.1161/CIRCULATIONAHA.106.174287.

    Article  PubMed  Google Scholar 

  51. Knackstedt C, Heymans S, Brunner-La Rocca HPICD. Implantation in patients with nonischemic heart failure. N Engl J Med. 2017;376(1):91–2. https://doi.org/10.1056/NEJMc1614441.

    PubMed  Google Scholar 

  52. Epstein AE, DiMarco JP, Ellenbogen KA, Estes NA 3rd, Freedman RA, Gettes LS, et al. 2012 ACCF/AHA/HRS focused update incorporated into the ACCF/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2013;61(3):e6–75. https://doi.org/10.1016/j.jacc.2012.11.007.

    Article  PubMed  Google Scholar 

  53. de Gonzalo-Calvo D, Quezada M, Campuzano O, Perez-Serra A, Broncano J, Ayala R, et al. Familial dilated cardiomyopathy: a multidisciplinary entity, from basic screening to novel circulating biomarkers. Int J Cardiol. 2017;228:870–80. https://doi.org/10.1016/j.ijcard.2016.11.045.

    Article  PubMed  Google Scholar 

  54. Kayvanpour E, Sedaghat-Hamedani F, Amr A, Lai A, Haas J, Holzer DB, et al. Genotype-phenotype associations in dilated cardiomyopathy: meta-analysis on more than 8000 individuals. Clin Res Cardiol. 2017;106(2):127–39. https://doi.org/10.1007/s00392-016-1033-6.

    Article  CAS  PubMed  Google Scholar 

  55. Seidelmann SB, Laur O, Hwa J, Depasquale E, Bellumkonda L, Sugeng L, et al. Familial dilated cardiomyopathy diagnosis is commonly overlooked at the time of transplant listing. J Heart Lung Transplant. 2016;35(4):474–80. https://doi.org/10.1016/j.healun.2015.12.002.

    Article  PubMed  Google Scholar 

  56. Manolis AS. Sudden death risk stratification in non-ischemic dilated cardiomyopathy using old and new tools: a clinical challenge. Expert Rev Cardiovasc Ther. 2017;15(4):315–25. https://doi.org/10.1080/14779072.2017.1307735.

    Article  CAS  PubMed  Google Scholar 

  57. Goldberger JJ, Subacius H, Patel T, Cunnane R, Kadish AH. Sudden cardiac death risk stratification in patients with nonischemic dilated cardiomyopathy. J Am Coll Cardiol. 2014;63(18):1879–89. https://doi.org/10.1016/j.jacc.2013.12.021.

    Article  PubMed  Google Scholar 

  58. Spezzacatene A, Sinagra G, Merlo M, Barbati G, Graw SL, Brun F, et al. Arrhythmogenic phenotype in dilated cardiomyopathy: natural history and predictors of life-threatening arrhythmias. J Am Heart Assoc. 2015;4(10):e002149. https://doi.org/10.1161/JAHA.115.002149.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Merlet P, Benvenuti C, Moyse D, Pouillart F, Dubois-Rande JL, Duval AM, et al. Prognostic value of MIBG imaging in idiopathic dilated cardiomyopathy. J Nucl Med. 1999;40(6):917–23.

    CAS  PubMed  Google Scholar 

  60. Jacobson AF, Senior R, Cerqueira MD, Wong ND, Thomas GS, Lopez VA, et al. Myocardial iodine-123 meta-iodobenzylguanidine imaging and cardiac events in heart failure. Results of the prospective ADMIRE-HF (AdreView Myocardial Imaging for Risk Evaluation in Heart Failure) study. J Am Coll Cardiol. 2010;55(20):2212–21. https://doi.org/10.1016/j.jacc.2010.01.014.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Cardiology, Rhode Island Hospital, Warren Alpert Medical School of Brown University, 593 Eddy Street, Providence, RI, 02908, USA

    Harsha V. Ganga & Abhishek Maan

  2. Cardiac Arrhythmia Service, Massachusetts General Hospital, GRB 109, 55 Fruit St., Boston, MA, 02114, USA

    E. Kevin Heist

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  1. Harsha V. Ganga
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Harsha V. Ganga declares that he has no conflict of interest.

Abhishek Maan: Medtronic (research grant), Biotronik (research grant), Biosense-Webster (research grant).

E. Kevin Heist: Boston Scientific (consultant, research grant), Biotronik (consultant, research grant), Medtronic (consultant), Pfizer (consultant), St. Jude Medical (consultant, research grant).

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Ganga, H.V., Maan, A. & Kevin Heist, E. Should Primary Prevention ICDs Still Be Placed in Patients with Non-ischemic Cardiomyopathy? A Review of the Evidence. Curr Cardiol Rep 20, 31 (2018). https://doi.org/10.1007/s11886-018-0974-y

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