Factors Associated With Non-Uptake of Implantable Cardioverter-Defibrillator (ICD) Among Eligible Patients at a Tertiary Hospital in Kenya.
Glob Heart
; 19(1): 66, 2024.
Article
in En
| MEDLINE
| ID: mdl-39157210
ABSTRACT
Background:
Efficacy of Implantable Cardioverter-Defibrillator (ICD) implantation in both primary and secondary prevention of Sudden Cardiac Death (SCD) in at-risk population is well established. ICD implantation rates remain low particularly in Africa with a paucity of data regarding factors associated with non-uptake.Objectives:
The primary study objective was to determine the factors associated with non-uptake of ICD among heart failure (HF) patients with reduced ejection fraction (EF<35%). Reasons for ICD refusal among eligible patients were reviewed as a secondary objective.Methods:
This was a retrospective study among HF patients eligible for ICD implantation evaluated between 2018 to 2020. Comparison between ICD recipient and non-recipient categories was made to establish determinants of non-uptake.Results:
Of 206 eligible patients, only 69 (33.5%) had an ICD. Factors independently associated with non-uptake were lack of private insurance (42.3% vs 63.8%; p = 0.005), non-cardiology physician (16.1% vs 5.8%; p = 0.045) and non-ischemic cardiomyopathy (54.7% vs 36.4% p = 0.014). The most common (75%) reason for ICD refusal was inability to pay for the device.Conclusion:
ICDs are underutilized among eligible HF with reduced EF patients in Kenya. The majority of patients without ICD had no private insurance, had non-ischemic cardiomyopathy and non-cardiology primary physician. Early referral of HF with reduced EF patients to HF specialists to optimize guideline-directed medical therapy and make ICD recommendation is needed.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Death, Sudden, Cardiac
/
Defibrillators, Implantable
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Tertiary Care Centers
/
Heart Failure
Limits:
Adult
/
Aged
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Female
/
Humans
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Male
/
Middle aged
Country/Region as subject:
Africa
Language:
En
Journal:
Glob Heart
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: