Characterization and financial impact of implantable cardioverter-defibrillator patients without interventions 5 years after implantation.
QJM
; 104(10): 849-57, 2011 Oct.
Article
em En
| MEDLINE
| ID: mdl-21624895
ABSTRACT
BACKGROUND:
Implantable cardioverter defibrillators (ICD's) are increasingly used for primary and secondary prevention of sudden cardiac death. However, data on how many ICD patients indeed receive appropriate ICD therapy during long-term follow-up is scarce.AIM:
The aim of our study was to determine the number of patients without appropriate ICD therapy 5 years after ICD implantation, to identify predicting factors, to assess the occurrence of late first ICD therapy and to quantify the financial impact of ICD therapy in a real-world setting.DESIGN:
Prospective observational study.METHODS:
We prospectively enrolled 322 consecutive ICD patients. Baseline data were collected at implantation and patients were followed for a median of 7.3 years (IQR 5.8-9.2 years). Time to first appropriate ICD therapy (either antitachycardia pacing or cardioversion) was documented.RESULTS:
Five years after implantation, 139 patients (43%) had not received appropriate ICD therapy. In multivariable analysis, a primary prevention indication and negative electrophysiological studies prior to ICD implantation were independent predictors of freedom from ICD therapy. Of the patients without ICD therapy, 5 years after implantation, 25% had experienced inappropriate ICD shocks. Two hundred and seven devices (1.5 devices per patient) were needed for the 139 patients without ICD intervention within 5 years, accounting for 31,784 per patient. During an additional follow-up of 3 years, 12% of the patients with unused ICD received a late first appropriate ICD therapy.CONCLUSION:
About half of the ICD patients receive appropriate ICD therapy within 5 years after implantation. Furthermore, there is a significant proportion of patients receiving late first shocks after five initially uneventful years.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Cardioversão Elétrica
/
Desfibriladores Implantáveis
Idioma:
En
Ano de publicação:
2011
Tipo de documento:
Article