Longevity of implantable cardioverter-defibrillators for cardiac resynchronization therapy in current clinical practice: An analysis according to influencing factors, device generation, and manufacturer

Maurizio Landolina, Antonio Curnis, Giovanni Morani, Antonello Vado, Ernesto Ammendola, Antonio D'Onofrio, Giuseppe Stabile, Martino Crosato, Barbara Petracci, Carlo Ceriotti, Luca Bontempi, Martina Morosato, Gian Paolo Ballari, Maurizio Gasparini

Research output: Contribution to journalArticle

Abstract

Aims Device replacement at the time of battery depletion of implantable cardioverter-defibrillators (ICDs) may carry a considerable risk of complications and engenders costs for healthcare systems. Therefore, ICD device longevity is extremely important both from a clinical and economic standpoint. Cardiac resynchronization therapy defibrillators (CRT-D) battery longevity is shorter than ICDs. We determined the rate of replacements for battery depletion and we identified possible determinants of early depletion in a series of patients who had undergone implantation of CRT-D devices. Methods and results We retrieved data on 1726 consecutive CRT-D systems implanted from January 2008 to March 2010 in nine centres. Five years after a successful CRT-D implantation procedure, 46% of devices were replaced due to battery depletion. The time to device replacement for battery depletion differed considerably among currently available CRT-D systems from different manufacturers, with rates of batteries still in service at 5 years ranging from 52 to 88% (log-rank test, P <0.001). Left ventricular lead output and unipolar pacing configuration were independent determinants of early depletion [hazard ratio (HR): 1.96; 95% 95% confidence interval (CI): 1.57-2.46; P <0.001 and HR: 1.58, 95% CI: 1.25-2.01; P <0.001, respectively]. The implantation of a recent-generation device (HR: 0.57; 95% CI: 0.45-0.72; P <0.001), the battery chemistry and the CRT-D manufacturer (HR: 0.64; 95% CI: 0.47-0.89; P = 0.008) were additional factors associated with replacement for battery depletion. Conclusion The device longevity at 5 years was 54%. High left ventricular lead output and unipolar pacing configuration were associated with early battery depletion, while recent-generation CRT-Ds displayed better longevity. Significant differences emerged among currently available CRT-D systems from different manufacturers.

Original languageEnglish
Pages (from-to)1251-1258
Number of pages8
JournalEuropace
Volume17
Issue number8
DOIs
Publication statusPublished - Jun 30 2015

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Keywords

  • Battery
  • CRT
  • Implantable defibrillator
  • Longevity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Landolina, M., Curnis, A., Morani, G., Vado, A., Ammendola, E., D'Onofrio, A., Stabile, G., Crosato, M., Petracci, B., Ceriotti, C., Bontempi, L., Morosato, M., Ballari, G. P., & Gasparini, M. (2015). Longevity of implantable cardioverter-defibrillators for cardiac resynchronization therapy in current clinical practice: An analysis according to influencing factors, device generation, and manufacturer. Europace, 17(8), 1251-1258. https://doi.org/10.1093/europace/euv109