---
title: "Early ICD Implantation After Out-of-Hospital Cardiac Arrest and 5-Year Mortality and Shock Rates"
id: "pubmed-42788874"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42788874"
content_type: "clinical_feed_article"
specialty: "Cardiology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42788874/"
doi: "10.1080/14017431.2026.2725365"
published_at: "2026-09-28T12:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Early ICD Implantation After Out-of-Hospital Cardiac Arrest and 5-Year Mortality and Shock Rates
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42788874
- **Specialty:** [Cardiology](https://medichelpline.com/clinical-feed/cardiology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42788874/)
- **DOI:** [10.1080/14017431.2026.2725365](https://doi.org/10.1080%2F14017431.2026.2725365)
- **Published At:** 2026-09-28T12:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Study evaluated long-term outcomes in patients resuscitated from **out-of-hospital cardiac arrest (OHCA)** of cardiac cause, without reversible cause, and with expected survival >1 year; patients were identified from 2007–2011. - Two groups compared: those with OHCA due to **acute coronary syndrome (ACS)** (n = 256) and those with primary arrhythmia (n = 258). - Primary comparisons: (1) incidence of early **ICD** implantation prior to hospital discharge, (2) cumulative first **shock** and anti-tachycardia pacing (ATP) therapy up to 5 years, and (3) 5-year mortality assessed by Cox regression. - Early ICD implantation rates differed markedly: ACS patients received ICDs in 30% of cases versus 82% in primary arrhythmia patients. - Cumulative 5-year incidence of appropriate ICD therapy (ATP and shock) did not differ significantly between groups: ATP — ACS 28% vs primary arrhythmia 27%; shock — ACS 22% vs primary arrhythmia 29%. - Crude 5-year mortality was lower among those who received an ICD in both groups: ACS no ICD 22% vs ICD 13%; primary arrhythmia no ICD 66% vs ICD 16%. - Adjusted analyses showed no mortality difference between ACS and primary arrhythmia groups overall (adjusted HRACS: 0.91, 95% CI 0.50–1.67) when comparing causes of arrest. - Early ICD implantation was independently associated with a reduced 5-year mortality risk after adjustment for cause of arrest, age >65 years, LVEF ≤35%, sex, and (for ACS) successful revascularization: HRACS 0.35 (95% CI 0.17–0.73) and HRPA 0.15 (95% CI 0.08–0.27). - Authors conclude cumulative incidences of appropriate therapy were similar regardless of cause of arrest, and early ICD implantation after OHCA was significantly and independently associated with lower 5-year mortality in both ACS and primary arrhythmia patients. - Detailed study design elements, inclusion/exclusion criteria beyond those stated, and other potential confounders or adverse events were not reported in the abstract supplied.
## Clinical Analysis & Structured Key Points
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Epub 2026 Sep 28. # Long-term mortality and shock-rate in patients surviving out-of-hospital cardiac arrest with and without early implantation of an implantable cardioverter defibrillator [Matilde Winther-Jensen](https://pubmed.ncbi.nlm.nih.gov/?term=Winther-Jensen+M&cauthor_id=42788874)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#full-view-affiliation-1 "Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#full-view-affiliation-2 "Section for Data, Biostatistics and Pharmacoepidemiology, Center for Clinical Research and Prevention, Frederiksberg Hospital, Frederiksberg, Denmark."), [Berit Thornvig Philbert](https://pubmed.ncbi.nlm.nih.gov/?term=Philbert+BT&cauthor_id=42788874)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#full-view-affiliation-1 "Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark."), [Marie L Laursen](https://pubmed.ncbi.nlm.nih.gov/?term=Laursen+ML&cauthor_id=42788874)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#full-view-affiliation-3 "Department of Cardiology, University Hospital Odense, Odense, Denmark."), [Jesper Kjaergaard](https://pubmed.ncbi.nlm.nih.gov/?term=Kjaergaard+J&cauthor_id=42788874)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#full-view-affiliation-1 "Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark."), [Tommi B Lindhardt](https://pubmed.ncbi.nlm.nih.gov/?term=Lindhardt+TB&cauthor_id=42788874)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#full-view-affiliation-4 "Department of Cardiology, University Hospital Gentofte, Gentofte, Denmark."), [Jacob E Møller](https://pubmed.ncbi.nlm.nih.gov/?term=M%C3%B8ller+JE&cauthor_id=42788874)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#full-view-affiliation-1 "Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#full-view-affiliation-3 "Department of Cardiology, University Hospital Odense, Odense, Denmark."), [Emilie Gregers](https://pubmed.ncbi.nlm.nih.gov/?term=Gregers+E&cauthor_id=42788874)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#full-view-affiliation-1 "Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark."), [Louise Linde](https://pubmed.ncbi.nlm.nih.gov/?term=Linde+L&cauthor_id=42788874)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#full-view-affiliation-3 "Department of Cardiology, University Hospital Odense, Odense, Denmark."), [Jens Brock Johansen](https://pubmed.ncbi.nlm.nih.gov/?term=Johansen+JB&cauthor_id=42788874)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#full-view-affiliation-3 "Department of Cardiology, University Hospital Odense, Odense, Denmark."), [Freddy K Lippert](https://pubmed.ncbi.nlm.nih.gov/?term=Lippert+FK&cauthor_id=42788874)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#full-view-affiliation-5 "Emergency Medical Services, Copenhagen, The Capital Region of Denmark."), [Lars Køber](https://pubmed.ncbi.nlm.nih.gov/?term=K%C3%B8ber+L&cauthor_id=42788874)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#full-view-affiliation-1 "Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#full-view-affiliation-6 "Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark."), [Helle Søholm](https://pubmed.ncbi.nlm.nih.gov/?term=S%C3%B8holm+H&cauthor_id=42788874)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#full-view-affiliation-1 "Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#full-view-affiliation-7 "Department of Cardiology, Skanes University Hospital, Lund, Sweden.") Affiliations Expand ### Affiliations * 1 Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. * 2 Section for Data, Biostatistics and Pharmacoepidemiology, Center for Clinical Research and Prevention, Frederiksberg Hospital, Frederiksberg, Denmark. * 3 Department of Cardiology, University Hospital Odense, Odense, Denmark. * 4 Department of Cardiology, University Hospital Gentofte, Gentofte, Denmark. * 5 Emergency Medical Services, Copenhagen, The Capital Region of Denmark. * 6 Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. * 7 Department of Cardiology, Skanes University Hospital, Lund, Sweden. * PMID: **42788874** * DOI: [ 10.1080/14017431.2026.2725365 ](https://doi.org/10.1080/14017431.2026.2725365) Free article Item in Clipboard Comparative Study # Long-term mortality and shock-rate in patients surviving out-of-hospital cardiac arrest with and without early implantation of an implantable cardioverter defibrillator Matilde Winther-Jensen et al. Scand Cardiovasc J. 2026 Dec. Free article Show details Display options Display options Format Abstract PubMed PMID Scand Cardiovasc J Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Scand+Cardiovasc+J%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Scand+Cardiovasc+J%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42788874/) . 2026 Dec;60(1):2725365. doi: 10.1080/14017431.2026.2725365. Epub 2026 Sep 28. ### Authors [Matilde Winther-Jensen](https://pubmed.ncbi.nlm.nih.gov/?term=Winther-Jensen+M&cauthor_id=42788874)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#short-view-affiliation-1 "Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#short-view-affiliation-2 "Section for Data, Biostatistics and Pharmacoepidemiology, Center for Clinical Research and Prevention, Frederiksberg Hospital, Frederiksberg, Denmark."), [Berit Thornvig Philbert](https://pubmed.ncbi.nlm.nih.gov/?term=Philbert+BT&cauthor_id=42788874)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#short-view-affiliation-1 "Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark."), [Marie L Laursen](https://pubmed.ncbi.nlm.nih.gov/?term=Laursen+ML&cauthor_id=42788874)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#short-view-affiliation-3 "Department of Cardiology, University Hospital Odense, Odense, Denmark."), [Jesper Kjaergaard](https://pubmed.ncbi.nlm.nih.gov/?term=Kjaergaard+J&cauthor_id=42788874)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#short-view-affiliation-1 "Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark."), [Tommi B Lindhardt](https://pubmed.ncbi.nlm.nih.gov/?term=Lindhardt+TB&cauthor_id=42788874)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#short-view-affiliation-4 "Department of Cardiology, University Hospital Gentofte, Gentofte, Denmark."), [Jacob E Møller](https://pubmed.ncbi.nlm.nih.gov/?term=M%C3%B8ller+JE&cauthor_id=42788874)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#short-view-affiliation-1 "Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.")[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#short-view-affiliation-3 "Department of Cardiology, University Hospital Odense, Odense, Denmark."), [Emilie Gregers](https://pubmed.ncbi.nlm.nih.gov/?term=Gregers+E&cauthor_id=42788874)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#short-view-affiliation-1 "Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark."), [Louise Linde](https://pubmed.ncbi.nlm.nih.gov/?term=Linde+L&cauthor_id=42788874)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#short-view-affiliation-3 "Department of Cardiology, University Hospital Odense, Odense, Denmark."), [Jens Brock Johansen](https://pubmed.ncbi.nlm.nih.gov/?term=Johansen+JB&cauthor_id=42788874)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#short-view-affiliation-3 "Department of Cardiology, University Hospital Odense, Odense, Denmark."), [Freddy K Lippert](https://pubmed.ncbi.nlm.nih.gov/?term=Lippert+FK&cauthor_id=42788874)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#short-view-affiliation-5 "Emergency Medical Services, Copenhagen, The Capital Region of Denmark."), [Lars Køber](https://pubmed.ncbi.nlm.nih.gov/?term=K%C3%B8ber+L&cauthor_id=42788874)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#short-view-affiliation-1 "Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#short-view-affiliation-6 "Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark."), [Helle Søholm](https://pubmed.ncbi.nlm.nih.gov/?term=S%C3%B8holm+H&cauthor_id=42788874)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#short-view-affiliation-1 "Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.")[ 7 ](https://pubmed.ncbi.nlm.nih.gov/42788874/#short-view-affiliation-7 "Department of Cardiology, Skanes University Hospital, Lund, Sweden.") ### Affiliations * 1 Department of Cardiology, The Heart Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark. * 2 Section for Data, Biostatistics and Pharmacoepidemiology, Center for Clinical Research and Prevention, Frederiksberg Hospital, Frederiksberg, Denmark. * 3 Department of Cardiology, University Hospital Odense, Odense, Denmark. * 4 Department of Cardiology, University Hospital Gentofte, Gentofte, Denmark. * 5 Emergency Medical Services, Copenhagen, The Capital Region of Denmark. * 6 Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. * 7 Department of Cardiology, Skanes University Hospital, Lund, Sweden. * PMID: **42788874** * DOI: [ 10.1080/14017431.2026.2725365 ](https://doi.org/10.1080/14017431.2026.2725365) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract **Introduction:** In patients who survive out-of-hospital cardiac arrest (OHCA), guidelines for implantation of an implantable cardioverter-defibrillator (ICD) are not unequivocal. **Methods:** Patients resuscitated from OHCA of cardiac cause, without a reversible cause and an expected survival >1 year, were identified (year 2007-2011). Patients with acute coronary syndrome (ACS) and primary arrhythmia were compared with respect to: (1) incidence of early ICD-implantation prior to hospital discharge, (2) first shock- and anti-tachycardia (ATP) therapy up to 5 years, and (3) 5-year mortality rate assessed by Cox-regression analyses. **Results:** ACS patients (_n_ = 256) less often had an ICD implanted compared to primary arrhythmia patients (_n_ = 258) (30% vs. 82%). Cumulative 5-year incidence of appropriate ICD-therapy did not differ (ATP; ACS: 28% vs. primary arrhythmia: 27%, shock; ACS: 22% vs. primary arrhythmia: 29%). Crude 5-year mortality was lower in ICD patients; ACS: No ICD: 22% vs. ICD: 13%; primary arrhythmia: No ICD; 66% vs. ICD: 16%. No difference in mortality between patients was noted (adjusted hazard ratio (HRACS): 0.91, 95% CI: 0.50-1.67). ICD implantation was independently associated with lower 5-year mortality risk in both patient groups after adjusting for cause of arrest, age > 65 years, left ventricular ejection fraction (LVEF) ≤35%, sex, and successful revascularization (in ACS only) (HRACS: 0.35, CI: 0.17-0.73, HRPA: 0.15, CI: 0.08-0.27). **Conclusions:** Cumulative incidences of appropriate therapy did not differ according to cause of arrest. Implantation of an early ICD after OHCA was significantly and independently associated with a lower 5-year mortality risk in both ACS and primary arrhythmia patients. **Keywords:** ATP; Out-of-hospital cardiac arrest; implantable cardioverter defibrillator; long-term outcome; shock. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ Association between socioeconomic factors and ICD implantation in a publicly financed health care system: a Danish nationwide study. ](https://pubmed.ncbi.nlm.nih.gov/29016817/) Winther-Jensen M, Hassager C, Lassen JF, Køber L, Torp-Pedersen C, Hansen SM, Lippert F, Christensen EF, Kragholm K, Kjaergaard J.Winther-Jensen M, et al.Europace. 2018 Jul 1;20(7):1129-1137. doi: 10.1093/europace/eux223.Europace. 2018.PMID: 29016817 * [ Evaluation of the Impact of a Chronic Total Coronary Occlusion on Ventricular Arrhythmias and Long-Term Mortality in Patients With Ischemic Cardiomyopathy and an Implantable Cardioverter-Defibrillator (the eCTOpy-in-ICD Study). ](https://pubmed.ncbi.nlm.nih.gov/29720502/) van Dongen IM, Yilmaz D, Elias J, Claessen BEPM, Delewi R, Knops RE, Wilde AAM, van Erven L, Schalij MJ, Henriques JPS.van Dongen IM, et al.J Am Heart Assoc. 2018 May 2;7(10):e008609. doi: 10.1161/JAHA.118.008609.J Am Heart Assoc. 2018.PMID: 29720502Free PMC article. * [ Implantable cardioverter-defibrillator therapy in pati
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