Schaer BA Kühne MS Blatter D Osswald S Sticherling C 2014 OBJECTIVE The implantable cardioverter defibrillator (ICD) is very effective in the prevention of sudden cardiac death, but its benefit is impaired by competing risks. A simple risk model to predict mortality was designed for patients with primary prevention and ischaemic cardiomyopathy. We aimed to apply this score to a general ICD population. METHODS This retrospective registry study included all patients in whom an ICD was implanted at a tertiary referral hospital. Risk factors were age >70 years, QRS width >120 ms, atrial fibrillation, New York Heart Association Functional Classification class >2 and glomerular filtration rate <60 mL/min/1.73 m(2). Kaplan-Meier curves were constructed according to the presence of 0, 1, 2 and >2 risk factors. RESULTS The cohort consists of 1032 patients, 881 (86%) were men, mean age was 61±14 years and mean follow-up 66±46 months. 256 patients (25%) died 58±41 months after implant. The setting was secondary prevention in 498 patients (48%). No risk factors was present in 32% of patients, 1 in 27%, 2 in 20% and >2 in 21%, respectively. There was a significant and comprehensible relation between risk score and mortality. Cumulative survival was 82% in patients with 0 risk factors, 63% in those with 1, 41% in those with 2 and 23% in those with >2 risk factors (p < 0.0001). ICD therapies were documented in 421 patients (41%) without correlation to risk factors. CONCLUSIONS In a mixed population of primary and secondary preventive ICD carriers, application of a simple risk score predicts long-term mortality but not appropriate use of the ICD. https://sonar.ch/global/documents/232224 eng info:eu-repo/semantics/altIdentifier/doi/10.1136/heartjnl-2013-305002 info:eu-repo/semantics/altIdentifier/pmid/24415667 Heart (British Cardiac Society). - 2014 Implantable cardioverter defibrillator sudden cardiac death ventricular fibrillation ventricular tachycardia Aged Death, Sudden, Cardiac Defibrillators, Implantable Female Follow-Up Studies Humans Kaplan-Meier Estimate Male Middle Aged Prognosis Retrospective Studies Risk Assessment Secondary Prevention Survival Rate Switzerland Tachycardia, Ventricular Application of a mortality risk score in a general population of patients with an implantable cardioverter defibrillator (ICD). http://purl.org/coar/resource_type/c_6501