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Neth Heart J
Neth Heart J
Netherlands Heart Journal
1568-5888
1876-6250
BSL Media & Learning Houten

39240449
1898
10.1007/s12471-024-01898-0
Letter to the Editor
Implantable cardioverter-defibrillators might not be necessary in all patients with idiopathic ventricular fibrillation
Noordman Alwin B. P.
http://orcid.org/0000-0002-7936-360X
Maass Alexander H. a.h.maass@umcg.nl

grid.4830.f 0000 0004 0407 1981 University Medical Centre Groningen, Department of Cardiology, University of Groningen, Groningen, The Netherlands
6 9 2024
6 9 2024
10 2024
32 10 365365
22 8 2024
© The Author(s) 2024
2024
https://creativecommons.org/licenses/by/4.0/ Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the articleʼs Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the articleʼs Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
issue-copyright-statement© The Society of Nederlandse Vereniging voor Cardiologie (NVVC) and Springer Media B.V. 2024
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pmcDear editor,

Verheul et al. present their important data from a Dutch registry of patients with idiopathic ventricular fibrillation (iVF) [1]. They underline the importance of comprehensive diagnostic testing to find a specific diagnosis. An underappreciated topic is prediction of future arrhythmic events as 74% of their patients do not experience appropriate ICD therapy. These young patients are prone to complications due to risk of electrode failure and need for multiple future interventions.

We previously demonstrated that secondary prevention patients with an unclear cause of ventricular arrhythmia received significantly less appropriate ICD therapy compared to those with a clear cause (14% vs. 41%). Considering that the rate of first appropriate therapy was highest in the first two years, [2] patients who do not receive appropriate therapy within the lifetime of their first ICD may not derive sufficient benefit to warrant ICD replacement.

We hope that the Dutch iVF registry can provide predictors for future arrhythmic events to optimally advise patients in the difficult decision-making process surrounding ICD replacement [3]. If we can identify patients with low risk of recurrence, ICD implantation may even be omitted altogether.

Funding

There was no funding obtained for this manuscript.

Conflict of interest

A.B.P. Noordman and A.H. Maass declare that they have no competing interests.
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References

1. Verheul LM Groeneveld SA Stoks J The Dutch idiopathic ventricular fibrillation registry: progress report on the quest to identify the unidentifiable Neth Heart J 2024 32 238 244 10.1007/s12471-024-01870-y 38653923
Verheul LM, Groeneveld SA, Stoks J, et al. The Dutch idiopathic ventricular fibrillation registry: progress report on the quest to identify the unidentifiable. Neth Heart J. 2024;32:238–44.38653923
2. Noordman ABP Rienstra M Blaauw Y Appropriate Implantable Cardioverter-Defibrillator therapy in patients with ventricular arrhythmia of unclear cause in secondary prevention of sudden cardiac death J Clin Med 2023 12 4479 10.3390/jcm12134479 37445514
Noordman ABP, Rienstra M, Blaauw Y, et al. Appropriate Implantable Cardioverter-Defibrillator therapy in patients with ventricular arrhythmia of unclear cause in secondary prevention of sudden cardiac death. J Clin Med. 2023;12:4479.37445514
3. Groenveld HF Coster JE van Veldhuisen DJ Downgrade of cardiac defibrillator devices to pacemakers in elderly heart failure patients: clinical considerations and the importance of shared decision-making Neth Heart J 2021 29 243 252 10.1007/s12471-021-01555-w 33710494
Groenveld HF, Coster JE, van Veldhuisen DJ, et al. Downgrade of cardiac defibrillator devices to pacemakers in elderly heart failure patients: clinical considerations and the importance of shared decision-making. Neth Heart J. 2021;29:243–52.33710494
