Atrial fibrillation history is statistically significantly associated with adverse major clinical outcomes in ICD-implanted HF patients .
Patients with AF have a higher risk of all-cause mortality , appropriate , and inappropriate ICD interventions compared with patients with no AF history .
AIMS To assess the association between atrial fibrillation ( AF ) and all-cause mortality and implantable cardioverter-defibrillators ( ICDs ) therapies  in heart failure ( HF ) patients with reduced ejection fraction and an ICD implanted .
Incidence of arrhythmias in a large cohort of patients with current implantable cardioverter-defibrillators in Spain: results from the UMBRELLA Registry.
AIMS The benefit of implantable cardioverter-defibrillators ( ICDs ) in patients at risk of sudden death has been established in r and omized clinical trials ( RCTs ) using the ICD models available at the time . However , observational large-scale data on the incidence of arrhythmias in up-to- date ICDs implanted according to the current guidelines are scarce . The aim was to assess the incidence of arrhythmias in a large , current ICD population based on a blinded peer review of the detected episodes . METHODS AND RESULTS UMBRELLA is a multicentre , observational registry of ICD patients followed by remote monitoring . Stored episodes were classified by a blinded committee of experts . Subgroup analyses were based on clinical profiles established by previous pivotal RCTs of ICDs . Of 1514 enrolled patients , 605 ( 39.9 % ) patients had 5951 episodes after 26 ± 17 months follow-up , being 3353 of them ( 56.3 % ) sustained ventricular arrhythmias ( SVA ) , and 13.2 % of SVA were self-terminated . Appropriate and inappropriate shocks occurred in 11.6 and 5 % of patients , respectively . The 3 years cumulative incidence of SVA was 25 % ( 95 % CI : 21 - 28 % ) in primary prevention patients and 41 % ( 95 % CI : 36 - 47 % ) in secondary prevention patients ( P < 0.001 ) . Male gender , secondary prevention , and atrial fibrillation as basal rhythm were significantly related to a higher incidence of SVA . CONCLUSION This real-world analysis suggests that  modern ICD patients have a low rate of appropriate and inappropriate shocks . The risk of SVA in secondary prevention patients is less than what has been reported in RCTs
Atrial fibrillation history is statistically significantly associated with adverse major clinical outcomes in ICD-implanted HF patients .
Patients with AF have a higher risk of all-cause mortality , appropriate , and inappropriate ICD interventions compared with patients with no AF history .
AIMS To assess the association between atrial fibrillation ( AF ) and all-cause mortality and implantable cardioverter-defibrillators ( ICDs ) therapies  in heart failure ( HF ) patients with reduced ejection fraction and an ICD implanted .