Abstract 17712: Similar Survival but Higher Incidence of Hardware-Related Complications in Female Implantable Cardioverter Defibrillator Recipients
Methods: We analyzed all consecutive ICD recipients implanted at our institution between 1/2000 and 12/2006. The all cause mortality, the annual and cumulative incidence of Re-Sx for ICD system complications was calculated. Data were analyzed according to the Kaplan-Meier method and compared for men and women.
Results: In 816 consecutive patients (pts; 81% male, 69% ischemic cardiomyopathy, 48% secondary prophylactic ICD indication) followed for 31±24 months (2113 cumulative pt-years), 98 patients died. No gender difference in the all cause mortality was observed (Hazard ratio (HR) for female patients: 0.92, 95% CI: 0.55–1.53, p=0.916). Of the 262 Re-Sx, 152 cases of normal battery depletion were excluded leaving 110 Re-Sx for ICD system complications, 5.2% per pt-year. Complications included lead-related problems (dislodgement, fracture, oversensing, exit block) in 81 (3.8 %) and generator-related problems (hardware/safety alert, pocket) in 29 pts (2.9%), including system infection in 4 pts (0.6%). The annual incidence of Re-Sx due to complication was 8.8% in women compared to 4.0% in men (HR 1.8, 95% CI: 1.2–2.8, p=0.006). Both generator- and ICD- lead-related complications were more often encountered in females (3.8% vs 0.7% per patient year, 5.0% vs 3.4%).
Conclusions: No gender difference was observed in the all cause mortality of ICD recipients. The incidence of complications requiring Re-Sx is considerable during ICD therapy even with modern technology and long-lasting experience. Female patients occur to be more prone for ICD hardware related complications.
- © 2010 by American Heart Association, Inc.