TY - JOUR
T1 - Longevity of implantable cardioverter-defibrillators for cardiac resynchronization therapy in current clinical practice
T2 - An analysis according to influencing factors, device generation, and manufacturer
AU - Landolina, Maurizio
AU - Curnis, Antonio
AU - Morani, Giovanni
AU - Vado, Antonello
AU - Ammendola, Ernesto
AU - D'Onofrio, Antonio
AU - Stabile, Giuseppe
AU - Crosato, Martino
AU - Petracci, Barbara
AU - Ceriotti, Carlo
AU - Bontempi, Luca
AU - Morosato, Martina
AU - Ballari, Gian Paolo
AU - Gasparini, Maurizio
PY - 2015/6/30
Y1 - 2015/6/30
N2 - 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.
AB - 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.
KW - Battery
KW - CRT
KW - Implantable defibrillator
KW - Longevity
UR - http://www.scopus.com/inward/record.url?scp=84939625250&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84939625250&partnerID=8YFLogxK
U2 - 10.1093/europace/euv109
DO - 10.1093/europace/euv109
M3 - Article
AN - SCOPUS:84939625250
VL - 17
SP - 1251
EP - 1258
JO - Europace
JF - Europace
SN - 1099-5129
IS - 8
ER -