Evidence mapPaperPMID 41711243Full record

SynthesisESC heart failure2026

Time to rethink ICD indications in non-ishaemic cardiomyopathy? Evidence from a meta-analysis across therapeutic eras.

Mislav Puljevic, Vedran Velagic, Hana Ivandic, Pero Hrabac, Marina Petrovic, Branimir Pervan

Abstract readMeta-Analysis
In one paragraph

Synthesis in ESC heart failure, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Real-world characteristics and management of ventricular tachycardias in ICD patients: Data from the VIDEO registry.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Mislav PuljevicCardiovascular Department, University Hospital Centre Zagreb, Kispaticeva 12, Zagreb 10000, Croatia.ORCID 0000-0003-1477-2581
Vedran VelagicCardiovascular Department, University Hospital Centre Zagreb, Kispaticeva 12, Zagreb 10000, Croatia.
Hana IvandicFaculty of Electrical Engineering and Computing, University of Zagreb, Unska 3, Zagreb 10000, Croatia.
Pero HrabacSchool of Medicine, University of Zagreb, Salata 3, Zagreb 10000, Croatia.
Marina PetrovicCardiovascular Department, University Hospital Centre Zagreb, Kispaticeva 12, Zagreb 10000, Croatia.
Branimir PervanFaculty of Electrical Engineering and Computing, University of Zagreb, Unska 3, Zagreb 10000, Croatia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Implantable cardioverter-defibrillators (ICDs) reduce sudden cardiac death (SCD) in non-ischaemic cardiomyopathy (NICM), but most evidence predates comprehensive guideline-directed medical therapy (GDMT). We quantified the relative and absolute survival benefit of primary-prevention ICDs in NICM across therapeutic eras and explored how contemporary GDMT modifies absolute benefit. We searched MEDLINE, Embase, and CENTRAL through March 2025 and included randomized controlled trials comparing prophylactic ICD implantation vs control in NICM with left ventricular ejection fraction ≤35%. Three trials (DEFINITE, SCD-HeFT NICM subgroup, and DANISH) contributed to the quantitative synthesis. ICD therapy reduced all-cause mortality (pooled hazard ratio (HR) 0.79, 95% confidence interval (CI) 0.66-0.95) and SCD (HR 0.44, 95% CI 0.28-0.70). Five-year absolute risk reduction (ARR) was 5.9% (NNT 17) in SCD-HeFT NICM and 4.4% (NNT 23) in DANISH. Under a full-GDMT scenario parameterized from pharmacological randomized controlled trials, projected baseline risk was ∼11%, yielding ARR 2.31% (NNT 43). All contemporary 'GDMT-era' absolute benefit estimates are scenario-based modelling outputs. No randomized trial has evaluated ICDs on top of full modern GDMT in NICM; therefore, these results represent illustrative ranges rather than empirical estimates.

Indexed as

CardiomyopathiesDeath, Sudden, CardiacDefibrillators, ImplantablePrimary PreventionHumansGuideline-directed medical therapyHeart failureImplantable cardioverter–defibrillatorMeta-analysisNon-ischaemic cardiomyopathySudden cardiac death

Identifiers

PMID41711243
PMCPMC13108307

What Socratic holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.