Alawi A Alsheikh-Ali, Ahmad S Hersi, Adel K S Hamad, Ahmed R Al Fagih, Faisal M Al-Samadi, Abdulmohsen M Almusaad, Fayez A Bokhari, Fawzia Al-Kandari, Bandar S Al-Ghamdi, Najib Al Rawahi, Nidal Asaad, Salem Alkaabi, Amin Daoulah, Hosam A Zaky, Omer Elhag, Yahya S Al Hebaishi, Raed Sweidan, Haitham Alanazi, David Chase, Hani Sabbour, Mohammad Al Meheiri, Ismail Al Abri, Mohammad Amin, Khaled Dagriri, Adil O Ahmed, Azam Shafquat, Shahul Hameed Khan

• ¹Division of Adult Cardiology, Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates; College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
• ²Department of Cardiac Sciences, King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia.
• ³Mohammed Bin Khalifa Bin Sulman AlKhalifa Cardiac Center, Bahrain Defense Force Hospital, Manama, Kingdom of Bahrain.
• ⁴Prince Sultan Cardiac Center, King Fahd Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia.
• ⁵King Salman Heart Center, King Fahd Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia.
• ⁶King Abdulaziz Cardiac Center, King Abdulaziz Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia.
• ⁷Division of Adult Cardiology, King Fahd Armed Forces Hospital, Jeddah, KSA.
• ⁸Division of Adult Cardiology, Chest Hospital, Kuwait Cardiac Center and Dabbous Cardiac Center, Kuwait City, Kuwait.
• ⁹Heart Center, King Faisal Specialist Hospital and Research Center, College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia.
• ¹⁰Division of Adult Cardiology, Royal Hospital, Muscat, Oman.
• ¹¹Division of Adult Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar.
• ¹²Division of Adult Cardiology, Zayed Military Hospital, Abu Dhabi, United Arab Emirates.
• ¹³Division of Adult Cardiology, King Faisal Specialist Hospital, Jeddah, Kingdom of Saudi Arabia.
• ¹⁴Division of Adult Cardiology, Dubai Hospital, Dubai, United Arab Emirates.
• ¹⁵Division of Adult Cardiology, Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates.

Background:
The implantable cardioverter-defibrillator (ICD) is effective in the prevention of sudden cardiac death in high-risk patients. Little is known about ICD use in the Arabian Gulf. We designed a study to describe the characteristics and outcomes of patients receiving ICDs in the Arab Gulf region.

Methods:
Gulf ICD is a prospective, multi-center, multinational, and observational study. All adult patients 18 years or older, receiving a de novo ICD implant and willing to sign a consent form will be eligible. Data on baseline characteristics, ICD indication, procedure and programing, in-hospital, and 1-year outcomes will be collected. Target enrollment is 1500 patients, which will provide adequate precision across a wide range of expected event rates.

Results:
Fifteen centers in six countries are enrolling patients (Saudi Arabia, United Arab Emirates, Kuwait, Oman, Bahrain, and Qatar). Two-thirds of the centers have dedicated electrophysiology laboratories, and in almost all centers ICDs are implanted exclusively by electrophysiologists. Nearly three-quarters of the centers reported annual ICD implant volumes of ≤150 devices, and pulse generator replacements constitute <30% of implants in the majority of centers. Enrollment started in December 2013, and accrual rate increased as more centers entered the study reaching an average of 98 patients per month.

Conclusions:
Gulf ICD is the first prospective, observational, multi-center, and multinational study of the characteristics and, the outcomes of patients receiving ICDs in the Arab Gulf region. The study will provide valuable insights into the utilization of and outcomes related to ICD therapy in the Gulf region.