P1683ICD use in arrhythmogenic right ventricular cardiomyopathy: prophylactic vs secondary indication
Bibliographic record
Abstract
Background: Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC) causes fibro-fatty scarring predominantly in the right ventricle and can lead to ventricular arrhythmias and sudden death (SD). The role of prophylactic ICD therapy is unknown. We report our long-term follow-up of ICD use for prophylactic and secondary indications in a cohort of patients with ARVC. Patients and methods: A retrospective chart review of all ARVC patients undergoing ICD implantation at a tertiary care center was performed, including both primary and secondary indications. Primary prevention ICDs were implanted based on suspected risk factors associated with an increased risk for SD including: SD in a first degree relative, marked RV involvement, LV involvement or TMEM43 genetic mutation. Patients with less than one year follow-up were excluded. All ICD events were adjudicated by two electrophysiologists. Results: 53 ARVC patients at our centre were included. Diagnosis of ARVC was made between the ages of 9.8 to 70.2 (mean 40.1) years in 32 males and 21 females. Follow-up after ICD implantation was for a mean of 11.5 years (range 1 - 21.3 yrs). ICD was indicated secondary to VT/VF in 19 (35.8%) and prophylactic in 34 (64.1%) pts. The table shows the results. Thirteen of 19 (68.4%) patients with prior VT/VF had appropriate ICD use due to recurrence of sustained VT or VF. Seven of 34 (20.5%) of primary prophylactic patients had appropriate ICD use. The prophylactic group is divided into those with (14) and those without (20) the TMEM43 genetic mutation. Six of the 14 TMEM43 mutation group had ICD use (42.8%). One of the non TMEM43 pts of the prophylactic group (5.0%) had ICD use. Two patients underwent cardiac transplantation. Nine secondary ICD patients and one prophylactic patient had catheter ablation for frequent VT/VF. There were three deaths (post transplant, heart failure,leukemia).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".