Effect of Dual-Organic Cations on the Structure and Properties of 2D Hybrid Perovskites as Scintillators.

Two-dimensional (2D) hybrid organic-inorganic perovskite (HOIP) crystals show promise as scintillating materials for wide-energy radiation detection, outperforming their three-dimensional counterparts. In this study, we synthesized single crystals of (PEA2-xBZAx)PbBr4 (x ranging from 0.1 to 2), utilizing phenethylammonium (C6H5CH2CH2NH3+) and benzylammonium (C6H5CH2NH3+) cations. These materials exhibit favorable optical and scintillation properties, rendering them suitable for high light yield (LY) and fast-response scintillators. Our investigation, employing various techniques such as X-ray diffraction (XRD), photoluminescence (PL), time-resolved (TR) PL, Raman spectroscopy, radioluminescence (RL), thermoluminescence (TL), and scintillation measurements, unveiled lattice strain induced by dual-organic cations in powder X-ray diffraction. Density functional theory analysis demonstrated a maximal 0.13 eV increase in the band gap with the addition of BZA cation addition. Notably, the largest Stokes shift of 0.06 eV was observed in (BZA)2PbBr4. The dual-organic cation crystals displayed >80% fast component scintillation decay time, which is advantageous for the scintillating process. Furthermore, we observed a dual-organic cations-induced enhancement of electron-hole transfer efficiency by up to 60%, with a contribution of >70% to the fast component of scintillation decay. The crystal with the lowest BZA concentration, (PEA1.9BZA0.1)PbBr4, demonstrated the highest LYs of 14.9 ± 1.5 ph/keV at room temperature. Despite a 55-70% decrease in LY for BZA concentrations >5%, simultaneous reductions in scintillation decay time (12-32%) may work for time-of-flight positron emission tomography and photon-counting computed tomography. Our work underscores the crucial role of dual-organic cations in advancing our understanding of 2D-HOIP crystals for materials science and radiation detection applications.

The Nanoplasmonic Purcell Effect in Ultrafast and High-Light-Yield Perovskite Scintillators.

The development of X-ray scintillators with ultrahigh light yields and ultrafast response times is a long sought-after goal. In this work, a fundamental mechanism that pushes the frontiers of ultrafast X-ray scintillator performance is theoretically predicted and experimentally demonstrated: the use of nanoscale-confined surface plasmon polariton modes to tailor the scintillator response time via the Purcell effect. By incorporating nanoplasmonic materials in scintillator devices, this work predicts over tenfold enhancement in decay rate and 38% reduction in time resolution even with only a simple planar design. The nanoplasmonic Purcell effect is experimentally demonstrated using perovskite scintillators, enhancing the light yield by over 120% to 88 ± 11 ph/keV, and the decay rate by over 60% to 2.0 ± 0.2 ns for the average decay time, and 0.7 ± 0.1 ns for the ultrafast decay component, in good agreement with the predictions of our theoretical framework. Proof-of-concept X-ray imaging experiments are performed using nanoplasmonic scintillators, demonstrating 182% enhancement in the modulation transfer function at four line pairs per millimeter spatial frequency. This work highlights the enormous potential of nanoplasmonics in optimizing ultrafast scintillator devices for applications including time-of-flight X-ray imaging and photon-counting computed tomography.

Interfacial interactions of doped-Ti3C2 MXene/MAPbI3 heterostructures: surfaces and the theoretical approach.

The work function (WF) of perovskite materials is essential for developing optoelectronic devices enabling efficient charge transfer at their interfaces. Perovskite's WF can be tuned by MXenes, a new class of two-dimensional (2D) early transition metal carbides, nitrides, and carbonitrides. Their variable surface terminations or the possibility of introducing elemental dopants could advance perovskites. However, the influence of doped-MXenes on perovskite materials is still not fully understood and elaborated. This study provides mechanistic insight into verifying the tunability of MAPbI3 WF by hybridizing with fluorine-terminated Ti3C2Tx (F-MXene) and nitrogen-doped Ti3C2Tx (N-MXene). We first reveal the interfacial interaction between MAPbI3 and MXenes via X-ray photoelectron spectroscopy (XPS), ultraviolet photoelectron spectroscopy (UPS), and photoluminescence spectroscopy (PL). UPS supported by density functional theory (DFT) calculations allowed the description of the influence of F and N on MXene's WF. Furthermore, we developed MAPbI3/MXene heterostructures using F- and N-MXenes. The F-MXenes extended the most WF of MAPbI3 from 4.50 eV up to 3.00 eV, compared to only a small shift for N-MXene. The underlying mechanism was charge transfer from low WF F-MXene to MAPbI3, as demonstrated by PL quenching in MAPbI3/F-MXene heterostructures. Altogether, this work showcases the potential of fluorine-doped MXenes over nitrogen-doped MXenes in advancing perovskite heterostructures, thus opening a door for efficient optoelectronic devices.

Lattice Expansion in Rb-Doped Hybrid Organic-Inorganic Perovskite Crystals Resulting in Smaller Band-Gap and Higher Light-Yield Scintillators.

Two-dimensional hybrid-organic-inorganic perovskite (2D-HOIP) lead bromide perovskite crystals have demonstrated great potential as scintillators with high light yields and fast decay times while also being low cost with solution-processable materials for wide energy radiation detection. Ion doping has been also shown to be a very promising avenue for improvements of the scintillation properties of 2D-HOIP crystals. In this paper, we discuss the effect of rubidium (Rb) doping on two previously reported 2D-HOIP single crystals, BA2PbBr4 and PEA2PbBr4. We observe that doping the perovskite crystals with Rb ions leads to an expansion of the crystal lattices of the materials, which also leads to narrowing of band gaps down to 84% of the pure compounds. Rb doping of BA2PbBr4 and PEA2PbBr4 shows a broadening in the photoluminescence and scintillation emissions of both perovskite crystals. Rb doping also leads to faster γ-ray scintillation decay times, as fast as 4.4 ns, with average decay time decreases of 15% and 8% for Rb-doped BA2PbBr4 and PEA2PbBr4, respectively, compared to those of undoped crystals. The inclusion of Rb ions also leads to a slightly longer afterglow, with residual scintillation still being below 1% after 5 s at 10 K, for both undoped and Rb-doped perovskite crystals. The light yield of both perovskites is significantly increased by Rb doping with improvements of 58% and 25% for BA2PbBr4 and PEA2PbBr4, respectively. This work shows that Rb doping leads to a significant enhancement of the 2D-HOIP crystal performance, which is of particular significance for high light yield and fast timing applications, such as photon counting or positron emission tomography.

Temperature dependent scintillation properties and mechanisms of (PEA)2PbBr4 single crystals.

In this work the scintillation properties of PEA2PbBr4 are studied as function of temperature, accessing the potential use of these materials for low temperature applications. The scintillation properties and mechanism have been studied using a combination of temperature dependent photoluminescence emission and excitation, X-ray excited emission and decay measurements. At room temperature the X-ray excited emission is dominated by the 442 nm emission with a lifetime of 35.2 ns. Under UV-Vis photon excitation an additional emission peak is observed at 412 nm. At 10 K, both X-ray and UV-Vis photon excited emission spectra show a narrow emission peak at 412 nm and a broad emission band centred around 525 nm with a lifetime of 1.53 ns (24%) and 154 ns (76%) respectively. The exact nature of the observed emission peaks is not known. For this reason two potential mechanisms explaining the difference between UV-Vis photon and X-ray excitation and their temperature dependent emissions are explored. The total spectral intensity decreases to 72% of the intensity at room temperature at 10 K. It is suggested that the observed negative thermal quenching behaviour results from a combination of more self absorption and a higher degree of self trapped exciton formation under X-ray excitation. Based on the observed fast decay component at 10 K and light yield of 9400 photons per MeV at room temperature, showing only a 28% decrease at 10 K, could make this material potentially interesting for low temperature and fast timing applications.

Stable and Bright Commercial CsPbBr3 Quantum Dot-Resin Layers for Apparent X-ray Imaging Screen.

CsPbBr3 quantum dots (QDs) have recently gained much interest due to their excellent optical and scintillation properties and their potential for X-ray imaging applications. In this study, we blended CsPbBr3 QDs with resin at different QD concentrations to achieve thick films and to protect the CsPbBr3 QDs from environmental moisture. Then, their scintillation properties are investigated and compared to the traditional commercial scintillators, CsI:Tl microcolumns, and Gadox layers. The CsPbBr3 QD-resin sheets show a high light yield of up to 21 500 photons/MeV at room temperature and a relatively small variation in light yield across a wide temperature range. In addition, the CsPbBr3 QD-resin sheets feature a small scintillation afterglow. The CsPbBr3 QD-resin sheets show a negligible trap density for the concentration below 50% weight, indicating that traps might arise from the aggregation of the QDs. The CsPbBr3 QD-resin sheets are also very stable at low irradiation intensities and relatively stable at higher intensities, with higher CsPbBr3 QD concentrations being more stable. Gamma-ray-excited-time-resolved emission measurements at 662 keV showed that the CsPbBr3 QD-resin sheets have an average scintillation decay time between 108 and 176 ns, which are still 10 000 and 6000 times faster than CsI:Tl and Gadox, respectively. Imaging tests show that the CsPbBr3 QD-resin sheets have a mean transfer function of 50% at 2 lp/mm and 20% at 4 lp/mm, comparable to that of commercial Gadox layers. This feature makes CsPbBr3 QD-resin sheets a good candidate for the low-cost, flexible X-ray imaging screens and γ-ray applications.

Scintillation in (C6H5CH2NH3)2SnBr4: green-emitting lead-free perovskite halide materials.

We report the optical and scintillation properties of (C6H5CH2NH3)2SnBr4 with excellent absorption length at 20 keV of 0.016 cm, measured bandgap of 2.51 eV, and photoluminescence lifetime of 1.05 µs. The light yield obtained with the 241Am source is 3600 ± 600 photons per MeV, which is much smaller than the maximum attainable light yield obtained from the bandgap. Temperature dependent radioluminescence measurements confirm the presence of thermal quenching at room temperature with the activation energy and the ratio between the attempt and the radiative transition rates of 61 meV and 129, respectively. Although thermal quenching affects light yield at room temperature, this green light-emitting perovskite opens an avenue for new lead-free scintillating materials.

Current Oscillations and Intermittent Emission Near an Electrode Interface in a Hybrid Organic-Inorganic Perovskite Single Crystal.

Hybrid organic-inorganic lead perovskites have a great potential in optoelectronic device applications because of their high stability, narrow band emission, and strong luminescence. Single crystals with few defects are the best candidates to disclose a variety of interesting and important properties for light-emitting devices. Here, we investigate a single-crystalline CH3NH3PbBr3 perovskite for its transport and electroluminescence properties. A simple fabrication method was used to obtain a 10 ± 2 µm channel between two gold wire electrodes, which showed bright intermittent electroluminescence near the interface of one wire after cooling down with a constant biasing voltage. The active region of the perovskite single crystal was pristine, well isolated from surroundings through fabrication to the characterization process. Our presented sample provided an ideal condition to study bulk ionic-electronic properties of hybrid halide perovskites. At constant 6 V bias, the current through the sample shows temperature-dependent oscillation with Arrhenius behavior, suggesting a thermally activated process. The light emission from the sample experiences an intermittent emission rate once every 26 ± 6 min. Here, we envisage that the current oscillations and intermittent emission are caused by ion-mediated negative differential resistance and conductive filament formation, respectively. The latter observation inspires future applications of the material from neuromorphic computing to the development of electroluminescence devices.

Brightness Enhancement in Pulsed-Operated Perovskite Light-Emitting Transistors.

Perovskite light-emitting field-effect transistors (PeLEFETs) provide a versatile device architecture to control transport and electroluminescence properties of hybrid perovskites, enabling injection of high charge carrier density and spatial control of the radiative recombination zone. Ionic screening and organic cation polarization effects typical of metal-halide perovskites, however, critically affect PeLEFET efficiency and reliability. In this work, we demonstrate a new device operation mode based on high-frequency modulation of the applied voltages, which allows significant reduction of ionic drift/screening in methylammonium lead iodide light-emitting transistors. In optimized top contact PeLEFETs, AC operation results in brighter and more uniform electroluminescence compared to DC-driven devices, whereas high-frequency modulation enables electroluminescence emission up to room temperature.

Simultaneous Extraction of Density of States Width, Carrier Mobility and Injection Barriers in Organic Semiconductors.

The predictive accuracy of state-of-the-art continuum models for charge transport in organic semiconductors is highly dependent on the accurate tuning of a set of parameters whose values cannot be effectively estimated either by direct measurements or by first principles. Fitting the complete set of model parameters at once to experimental data requires to set up extremely complex multi-objective optimization problems whose solution is, on the one hand, overwhelmingly computationally expensive and, on the other, it provides no guarantee of the physical soundness of the value obtained for each individual parameter. In the present study we present a step-by-step procedure that enables to determine the most relevant model parameters, namely the density of states width, the carrier mobility and the injection barrier height, by fitting experimental data from a sequence of relatively simple and inexpensive measurements to suitably devised numerical simulations. At each step of the proposed procedure only one parameter value is sought for, thus highly simplifying the numerical fitting and enhancing its robustness, reliability and accuracy. As a case study we consider a prototypical n-type organic polymer. A very satisfactory fitting of experimental measurements is obtained, and physically meaningful values for the aforementioned parameters are extracted.

The contribution of intramyocardial hemorrhage to the "no-reflow phenomenon": a study performed by cardiac magnetic resonance.

BACKGROUND: Percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) is sometimes complicated by microvascular damage and hemorrhage. Hemoglobin degradation products have magnetic susceptibility effects which help in detecting hemorrhagic AMI by T2 -weighted cardiac magnetic resonance (CMR) images. OBJECTIVES: To investigate the possibility to detect intramyocardial hemorrhage after AMI and to assess its contribution to the delayed hypoenhanced core on late gadolinium enhancement (LGE) CMR, a feature traditionally referred to as microvascular obstruction. METHODS: Consecutive patients with AMI who underwent PCI and CMR were investigated. Hypointense zones T2 -weighted images were labelled as "hemorrhagic" AMI. Areas of late hypoenhancement on LGE CMR were considered as regions of persistent microvascular damage (PMD). Only transmural AMI were considered. RESULTS: A total number of 108 transmural AMI patients were eventually enrolled and divided into two groups according to the presence of hypoenhancement on T2 images. Thirty-two patients showed an hypointense stria within the high signal intensity zone on T2 -weighted images; all these patients showed midmural PMD on LGE. Among the remaining 76 patients, only 14 (18.4%) showed PMD in the subendocardial region. The angiographic outcome was worse in patients with hemorrhagic AMI, with a lower prevalence of TIMI 3 (65.6% vs. 96.1%, P = 0.017) and higher prevalence of myocardial blush grade 0 (84.4% vs. 13.2%, P < 0.001) post-PCI. CONCLUSIONS: T2 -weighted CMR in reperfused AMI allows identification of hemorrhage, related to PMD areas on LGE images and to a worse reperfusion profile on angiography. These features open new avenues of investigation for prognostic assessment of reperfused AMI.

Relationship between myocardial blush grades, staining, and severe microvascular damage after primary percutaneous coronary intervention a study performed with contrast-enhanced magnetic resonance in a large consecutive series of patients.

BACKGROUND: Although angiographic perfusion has been traditionally evaluated by myocardial blush grade (MBG), pathophysiologic features underlying different MBG and the persistent blush, traditionally called staining, have been poorly explained. The aim of the study was to evaluate the correlation between MBG and morphologic aspects on cardiac magnetic resonance (CMR). METHODS: Myocardial blush grade and morphologic aspects on contrast-enhanced CMR, with special reference to staining phenomenon and persistent microvascular damage (PMD), were evaluated in a consecutive series of patients with acute myocardial infarction (AMI) treated by primary percutaneous coronary intervention. RESULTS: A total number of 294 AMI patients were enrolled and classified into 2 groups, that is, MBG 0/1 (115, 39%) and MBG 2/3 (179, 61%), according to the angiographic profile. By comparing MBG 0/1 versus MBG 2/3 patients, the former exhibited a larger enzymatic infarct size (P < .001) and a greater infarct size index (P < .001) and PMD (P < .001). In the MBG 0/1 group, a subgroup of 51 patients with staining phenomenon (MBG 0 staining) was also identified, with a worse CMR profile as PMD (P < .001). Multivariate analysis confirmed the strong association between MBG 0/1 and mean number of segments with transmural necrosis (odds ratio 1.62, 95% CI 1.17-2.24, P = .003) and PMD index (odds ratio 3.13, 95% CI 1.19-8.29, P = .021). CONCLUSIONS: In AMI patients treated by primary percutaneous coronary intervention, angiographic parameters of impaired reperfusion correlate with PMD as detected by contrast CMR. Among patients with MBG 0, the presence of the so-called staining phenomenon identifies a subgroup of patients with more severe PMD.

Comparison of clinical features of arrhythmogenic right ventricular cardiomyopathy in men versus women.

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a heart muscle disease characterized by myocardial necrosis followed by fibrous-fatty replacement. The pathologic process constitutes the basis for ventricular arrhythmias due to re-entrant circuits. Even if this genetic disease is transmitted in the majority of cases with autosomal dominant trait, in all reported series ARVC is prevalent in men. In this study we investigate the impact that gender may have on clinical presentation in a large series of patients with ARVC. A total of 171 consecutive patients (mean 29 +/- 12 years, range 13 to 65) affected by ARVC were examined with family and personal history, 12-lead electrocardiogram (ECG), 24-hour ECG, signal-averaged ECG, and echocardiogram. Moreover, electrophysiological study and ventricular angiography were performed in selected cases. In the 171 subjects, 71% were men and 29% women (p = 0.02). No gender differences were found considering the age at the time of diagnosis and of study enrolment and the prevalence of index cases and family members. The genders differed in prevalence of abnormal ECG (69% vs 52%, p = 0.036) and presence of late potentials (60% vs 40%, p = 0.01). Moreover, men had larger right ventricular dimensions and practiced competitive sports more frequently (26% vs 14%, p <0.001). Nonetheless, gender was not associated with a high incidence of life-threatening ventricular arrhythmias or with a poor outcome. In conclusion, our data show that diagnosis of ARVC is less common in female patients, who present a higher prevalence of mild forms. Nonetheless, the degree of electrical instability does not differ significantly between genders in affected subjects. Even if ARVC remains mainly a male disease, gender does not have a role in patients' outcome. The cause of the under-representation of women is not clear, even if potentially important factors such as sexual hormones and physical activity could play a role.

Quantitative assessment of endomyocardial biopsy in arrhythmogenic right ventricular cardiomyopathy/dysplasia: an in vitro validation of diagnostic criteria.

AIMS: To provide a standardized endomyocardial biopsy (EMB) protocol and diagnostic quantitative parameters for arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D). The Task Force criteria for the in vivo diagnosis of ARVC/D include tissue characterization by EMB as a major criterion. METHODS AND RESULTS: EMBs were simulated in vitro with a Cordis bioptome in explanted hearts from six groups: diffuse (n = 10) and segmental (n = 10) ARVC/D, dilated cardiomyopathy (DC) (n = 10), controls (n = 10), adipositas cordis (n = 10), elderly >80 years (n = 10). Sampling sites were the RV inferior-subtricuspid, antero-apical, and mid-outflow tract (RVOT), the septum, and the left ventricle (LV). Histomorphometry was performed to evaluate the amount of myocardium and fibrous and fatty tissues. Myocyte diameters and abnormalities were also assessed. By selecting a 95% specificity, the ARVC/D diagnostic cut-offs on cumulative RV EMB samples are myocardium <59%, fibrosis >31% and fat >22% (80, 50, and 50% sensitivity, respectively). By excluding elderly and obese people groups a lower cut-off for fat was found (>9%). A high variability between different RV sampling sites was observed; the antero-apical was the most informative region although fat at this level is non-specific. No useful diagnostic cut-off for fatty tissue was identified at the antero-apical and RVOT area. No significant difference was found for any tissue parameter either in septal or in LV EMB. Increased RV myocyte diameters and cytological changes were detected in ARVC/D and DC. CONCLUSION: The residual myocardium is the main diagnostic morphometric parameter in ARVC/D, whereas fat at the apex is non-specific. Sensitivity and specificity vary according to the RV region. Target sampling of the triangle of dysplasia is required, although only a single region is often informative, emphasizing the usefulness of imaging-guided EMB. There is no diagnostic value of either septal or LV EMB. Cardiomyopathic changes of the myocytes also appear important for establishing a pathological diagnosis.

Pressure response to vasopressors and mortality after direct angioplasty for cardiogenic shock.

BACKGROUND: There is very little known about the relationship between pre-intervention arterial pressure response to vasopressor therapy (PRV) and death rate, after primary angioplasty for immediate cardiogenic shock (CS) complicating acute myocardial infarction (AMI). METHODS: We examined data from 32 consecutive cases, admitted to our department within 12 h after the onset of MI and in CS, treated with direct PTCA, from May 1995 to March 2001. Intravenous administration of dobutamine and vasopressor agents was required in all patients before intervention. RESULTS: Ten patients, after vasopressor therapy, showed a significant improvement in systolic arterial pressure, invasively measured, (>90 mmHg, responders) before undergoing PTCA. Responders were younger and with less impaired pre-procedural LVEF (39.6%+/-10.7 vs. 30.9%+/-8.4, P=0.02). After direct PTCA responders showed an improved final TIMI flow (2.8+/-0.6 vs. 2.2+/-0.7, P=0.04) and blush grade (1.9+/-0.9 vs. 1+/-1, P=0.03). The mortality rate was lower in responders compared with non-responders both in hospital (20% vs. 68%, P=0.02) and at 3.5 years of follow-up (30% vs. 73%, P=0.049). After adjustment by multivariate analysis older age and lower blush grade correlated with in hospital death, while age remained the only predictor of late death. CONCLUSIONS: PRV was not an independent predictor of death after direct PTCA for CS. The association of no PRV with older age and lower post procedural blush grade may explain the difference in mortality rates between responders and non-responders.

In vivo synthesized proteins with monoexponential fluorescence decay kinetics.

Tryptophan, when in a protein, typically shows multiexponential fluorescence decay kinetics. Complex kinetics prevents a straightforward interpretation of time-resolved fluorescence protein data, particularly in anisotropy studies or if the effect of a dynamic quencher or a resonance energy transfer (RET) acceptor is investigated. Here, time-resolved fluorescence data are presented of an isosteric tryptophan analogue, 5-fluorotryptophan, which when biosynthetically incorporated in proteins shows monoexponential decay kinetics. Data are presented indicating that the presence of a fluoro atom at the 5-position suppresses the electron transfer rate from the excited indole moiety to the peptide bond. This process has been related to the multiexponential fluorescence decay of tryptophan in proteins. The monoexponential decay of 5-fluorotryptophan makes it possible to measure simultaneously multiple distances between 5-fluorotryptophan and a RET acceptor. We demonstrate that for an oligomeric protein, consisting of two single-tryptophan-containing subunits, the individual distances between 5-fluorotryptophan and the single substrate binding site can be resolved using a substrate harboring a RET acceptor.

Implantable cardioverter-defibrillator therapy for prevention of sudden death in patients with arrhythmogenic right ventricular cardiomyopathy/dysplasia.

BACKGROUND: Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is a condition associated with the risk of sudden death (SD). METHODS AND RESULTS: We conducted a multicenter study of the impact of the implantable cardioverter-defibrillator (ICD) for prevention of SD in 132 patients (93 males and 39 females, age 40+/-15 years) with ARVC/D. Implant indications were a history of cardiac arrest in 13 patients (10%), sustained ventricular tachycardia in 82 (62%), syncope in 21 (16%), and other in 16 (12%). During a mean follow-up of 39+/-25 months, 64 patients (48%) had appropriate ICD interventions, 21 (16%) had inappropriate interventions, and 19 (14%) had ICD-related complications. Fifty-three (83%) of the 64 patients with appropriate interventions received antiarrhythmic drug therapy at the time of first ICD discharge. Programmed ventricular stimulation was of limited value in identifying patients at risk of tachyarrhythmias during the follow-up (positive predictive value 49%, negative predictive value 54%). Four patients (3%) died, and 32 (24%) experienced ventricular fibrillation/flutter that in all likelihood would have been fatal in the absence of the device. At 36 months, the actual patient survival rate was 96% compared with the ventricular fibrillation/flutter-free survival rate of 72% (P<0.001). Patients who received implants because of ventricular tachycardia without hemodynamic compromise had a significantly lower incidence of ventricular fibrillation/flutter (log rank=0.01). History of cardiac arrest or ventricular tachycardia with hemodynamic compromise, younger age, and left ventricular involvement were independent predictors of ventricular fibrillation/flutter. CONCLUSIONS: In patients with ARVC/D, ICD therapy provided life-saving protection by effectively terminating life-threatening ventricular arrhythmias. Patients who were prone to ventricular fibrillation/flutter could be identified on the basis of clinical presentation, irrespective of programmed ventricular stimulation outcome.