Abstract 19716: The Cardiovascular Research Network Longitudinal Study of Implantable Cardioverter Defibrillators: ICD Therapy in a Community Population
Background: Implantable cardioverter defibrillators (ICDs) are increasingly used for the primary prevention of sudden cardiac death in patients with left ventricular systolic dysfunction (LVSD). Despite the expense and potential complications of this therapy, little is known about representative community-based populations undergoing ICD implantation and their outcomes.
Methods: The Longitudinal Study of ICDs (LSICD) is designed to study patients with LVSD undergoing primary prevention ICD implantation between 1/2006 and 12/2009 in 7 large health plans in the HMO Research Network Cardiovascular Research Network (CVRN). The database will be comprised of 3 sources, including 1) the National Cardiovascular Data Registry for ICDs, which provides detailed baseline clinical data; 2) the CVRN virtual data warehouse, which provides longitudinal information on outcomes over at least 3 years of follow-up, and 3) an adjudicated database of ICD therapies (i.e. shocks and anti-tachycardia pacing). After the collection of outcomes data, the study will assess the rates and correlates of mortality, hospitalization, device-related complications, and ICD therapies. In this report, we compare the baseline characteristics of the patient population compared with those of landmark primary prevention ICD trials.
Results: To this point, 1,492 patients have accrued with a target of at least 2,500. Compared with patients studied in landmark primary prevention ICD trials, the CVRN population is significantly older, more often female, has more advanced HF symptoms, and has significantly higher rates of important coexisting illnesses (Table).
Conclusions: The population of the LSICD differs substantially from those of the trials that inform decisions around primary prevention ICD implantation. The future work with this cohort will improve decision-making by exploring important clinical outcomes in this real-world population.
- Implantable cardioconvert defibrillator
- Health services research
- Arrhythmias, treatment of
- © 2010 by American Heart Association, Inc.