Abstract 11989: Longevity of Implantable Cardioverter-Defibrillators in a Large Real-Life Single Center Population
Purpose: Real-life comparative data of implantable cardioverter-defibrillator (ICD) longevity are necessary to identify the best possible device longevity for optimal patient comfort, and minimized risk at potentially multiple replacements.
Methods: We retrospectively studied ICD longevity in a large single-center population. At our institution, 1272 consecutive pts underwent ICD or CRT-D implantation between 1998 and 2010. Device data and follow up (FU) were retrieved from the continuous ICD clinic documentation, generator replacements were verified from the hospital charts. Kaplan-Meier (KM) event probabilities for the time to generator replacement were calculated according to device type, pacing percentage and threshold, incidence of ICD shocks, and manufacturer. The results of the Cox regression model, including hazard ratios (HR), and confidence intervals (CI) are given in the table.
Results: Mean age was 64±13 yrs, left ventricular ejection fraction averaged 30±11 %, 81% pts were male, and 60% received their ICD for primary prophylaxis. A total of 1666 devices were implanted, 470 of them (single-/dual-chamber/CRT-D: Boston Sc./Guidant, BSC, 62/58/55; Medtronic, MDT, 45/108/113; and Biotronik, BTK, 11/18/0) were replaced after 5.2±1.3 yrs (BSC) resp. 5.7±1.7 yrs (MDT) resp. 5.1±0.8 yrs (BTK), see Figure for KM curve. The results of the final Cox regression model, including hazard ratios (HR), and confidence intervals (CI) are given in the table.
Conclusions: ICD longevity differed significantly between manufacturers, and independently so from device type or pacing parameters. Performance of MDT devices was superior to BSC, both were superior to BTK.
- © 2013 by American Heart Association, Inc.