LAUSR

Key Points Question What are the trends and variability in use of single- and dual-chamber implantable cardioverter-defibrillators (ICDs) among patients undergoing ICD implantation without a pacing indication? Findings In this cross-sectional study of 266 182 patients undergoing first-time ICD implantation without a pacing indication, the use of dual-chamber ICDs decreased. However, there was persistent variation in use of the devices despite adjustment for patient characteristics. Meaning In this cross-sectional study of patients in contemporary practice undergoing first-time ICD implantation without a pacing indication, institutional variability in the use of atrial leads appears to persist, suggesting differences in individual or institutional cultures of real-world practice and opportunity to reduce this low-value practice.