Longevity of implantable cardioverter-defibrillators in a single-center population

Background or purpose Real-life comparative data of implantable cardioverter-defibrillator (ICD) longevity are needed to identify the best possible device longevity for optimal patient comfort and to minimize risk for multiple replacements. Methods We retrospectively studied ICD longevity in a large...

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Bibliographic Details
Published in:Journal of interventional cardiac electrophysiology 2015-11, Vol.44 (2), p.179-186
Main Authors: Seegers, Joachim, Expósito, Pascal Muñoz, Lüthje, Lars, Fischer, Thomas, Lueken, Matthias, Wenk, Hannes, Sossalla, Samuel T., Hasenfuss, Gerd, Zabel, Markus
Format: Article
Language:English
Subjects:
Cardiology
Defibrillators, Implantable - statistics & numerical data
Device Removal - statistics & numerical data
Electric Power Supplies - statistics & numerical data
Equipment Failure - statistics & numerical data
Equipment Failure Analysis - statistics & numerical data
Female
Germany - epidemiology
Heart Failure - mortality
Heart Failure - prevention & control
Humans
Longitudinal Studies
Male
Medicine
Medicine & Public Health
Middle Aged
Prevalence
Risk Factors
Survival Analysis
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Summary:Background or purpose Real-life comparative data of implantable cardioverter-defibrillator (ICD) longevity are needed to identify the best possible device longevity for optimal patient comfort and to minimize risk for multiple replacements. Methods We retrospectively studied ICD longevity in a large single-center population. At our institution, 1272 consecutive patients were implanted with 1665 ICD or cardiac resynchronization therapy with defibrillator (CRT-D) devices between 1998 and 2010. Device data and follow-up were retrieved from the continuous ICD clinic documentation, and generator replacements were verified from the hospital charts. Kaplan-Meier event probabilities for the time to generator replacement were calculated according to device type, pacing percentage (sum of atrial, right and left ventricular pacing, if applicable) and right ventricular pacing threshold, incidence of ICD shocks, and manufacturer. Multivariate Cox proportional hazards regression was performed in addition. Results A total of 470 devices were replaced for elective replacement indicator. These occurred after 5.4 years (95 % confidence interval, 5.1 to 5.6 years) in 175 of 625 implanted Boston Scientific or Guidant devices, after 5.7 years (5.5 to 5.9 years) in 266 of 883 Medtronic devices, and 5.2 years (5.0 to 5.4 years) in 29 of 157 Biotronik devices, respectively. Differences between manufacturers remained significant upon multivariate analysis (Medtronic vs. Boston Scientific: P  = 0.01; both vs. Biotronik: P  
ISSN:1383-875X
1572-8595
DOI:10.1007/s10840-015-0044-y