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

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

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 < 0.01) as did differences of device type (single- and dual-chamber ICD vs. CRT-D, P < 0.01) and pacing percentage (P < 0.01). Pacing output and ICD shocks did not influence battery longevity.

Conclusion

ICD longevity differed significantly between manufacturers, independent of device type or pacing parameters.

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Abbreviations

ATP:

Antitachycardia pacing

CI:

Confidence interval

CRT-D:

Cardiac resynchronization therapy with defibrillator

DDD:

Dual-chamber device

ERI:

Elective replacement indicator

HR:

Hazard ratio

ICD:

Implantable cardioverter-defibrillator

RV:

Right ventricular

SCD:

Sudden cardiac death

VVI:

Single-chamber device

VF:

Ventricular fibrillation

VT:

Ventricular tachycardia

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Acknowledgments

The research leading to the results has received funding from the European Community’s Seventh Framework Programme FP7/2007–2013 under grant agreement no. 602299, EU-CERT-ICD.

Conflict of interest

J. S., L. L., S. T. S., and M. Z. received travel grant support from Boston Scientific, Biotronik, and Medtronic. M. Z. received lecture fees and consultant fees from Medtronic, Biotronik, and Boston Scientific. P. M., T. F., M. L., H. W., and G. H. have no conflict of interest.

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Authors and Affiliations

  1. Department of Cardiology and Pneumology and Clinical Electrophysiology Division, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany

    Joachim Seegers, Pascal Muñoz Expósito, Lars Lüthje, Thomas Fischer, Matthias Lueken, Hannes Wenk, Samuel T. Sossalla, Gerd Hasenfuss & Markus Zabel

  2. Department of Internal Medicine II, Division of Cardiology, University Hospital Regensburg, Regensburg, Germany

    Joachim Seegers

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  1. Joachim Seegers
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  2. Pascal Muñoz Expósito
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Correspondence to Markus Zabel.

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Seegers, J., Expósito, P.M., Lüthje, L. et al. Longevity of implantable cardioverter-defibrillators in a single-center population. J Interv Card Electrophysiol 44, 179–186 (2015). https://doi.org/10.1007/s10840-015-0044-y

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  • DOI: https://doi.org/10.1007/s10840-015-0044-y

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