Longevity of implantable cardioverter-defibrillators for cardiac resynchronization therapy in current clinical practice: an analysis according to influencing factors, device generation, and manufacturer.
Europace
; 17(8): 1251-8, 2015 Aug.
Article
em En
| MEDLINE
| ID: mdl-25976906
ABSTRACT
AIMS:
Device replacement at the time of battery depletion of implantable cardioverter-defibrillators (ICDs) may carry a considerable risk of complications and engenders costs for healthcare systems. Therefore, ICD device longevity is extremely important both from a clinical and economic standpoint. Cardiac resynchronization therapy defibrillators (CRT-D) battery longevity is shorter than ICDs. We determined the rate of replacements for battery depletion and we identified possible determinants of early depletion in a series of patients who had undergone implantation of CRT-D devices. METHODS ANDRESULTS:
We retrieved data on 1726 consecutive CRT-D systems implanted from January 2008 to March 2010 in nine centres. Five years after a successful CRT-D implantation procedure, 46% of devices were replaced due to battery depletion. The time to device replacement for battery depletion differed considerably among currently available CRT-D systems from different manufacturers, with rates of batteries still in service at 5 years ranging from 52 to 88% (log-rank test, P < 0.001). Left ventricular lead output and unipolar pacing configuration were independent determinants of early depletion [hazard ratio (HR) 1.96; 95% 95% confidence interval (CI) 1.57-2.46; P < 0.001 and HR 1.58, 95% CI 1.25-2.01; P < 0.001, respectively]. The implantation of a recent-generation device (HR 0.57; 95% CI 0.45-0.72; P < 0.001), the battery chemistry and the CRT-D manufacturer (HR 0.64; 95% CI 0.47-0.89; P = 0.008) were additional factors associated with replacement for battery depletion.CONCLUSION:
The device longevity at 5 years was 54%. High left ventricular lead output and unipolar pacing configuration were associated with early battery depletion, while recent-generation CRT-Ds displayed better longevity. Significant differences emerged among currently available CRT-D systems from different manufacturers.Palavras-chave
Texto completo:
1
Temas:
ECOS
/
Avaliacao_tecnologia
Bases de dados:
MEDLINE
Assunto principal:
Fontes de Energia Elétrica
/
Desfibriladores Implantáveis
/
Remoção de Dispositivo
/
Insuficiência Cardíaca
/
Indústrias
Tipo de estudo:
Clinical_trials
/
Health_technology_assessment
/
Prognostic_studies
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
Europace
Assunto da revista:
CARDIOLOGIA
/
FISIOLOGIA
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Itália