Document Detail


Analysis of implantable defibrillator longevity under clinical circumstances: implications for device selection.
MedLine Citation:
PMID:  19796344     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Information about implantable cardioverter-defibrillator (ICD) longevity is mostly calculated from measurements under ideal laboratory conditions. However, little information about longevity under clinical circumstances is available. This survey gives an overview on ICD service times and generator replacements in a cohort of consecutive ICD patients. METHODS: Indications for replacement were classified as a normal end-of-service (EOS), premature EOS, system malfunction, infection and device advisory, or recall actions. From the premature and normal EOS group, longevity from single-chamber (SC), dual-chamber (DC), and cardiac resynchronization therapy defibrillator (CRT-D), rate-responsive (RR) settings, high output (HO) stimulation, and indication for ICD therapy was compared. Differences between brands were compared as well. RESULTS: In a total of 854 patients, 203 ICD replacements (165 patients) were recorded. Premature and normal EOS replacements consisted of 32 SC, 98 DC and 24 CRT-D systems. Longevity was significantly longer in SC systems compared to DC and CRT-D systems (54 +/- 19 vs. 40 +/- 17 and 42 +/- 15 months; P = 0.008). Longevity between non-RR (n = 143) and RR (n = 11) settings was not significantly different (43 +/- 18 vs. 45 +/- 13 months) as it also was not for HO versus non-HO stimulation (43 +/- 19 vs. 46 +/- 17 months). Longevity of ICDs was not significantly different between primary and secondary prevention (42 +/- 19 vs. 44 +/- 18 months). The average longevity on account of a device-based EOS message was 43 +/- 18 months. Average longevity for Biotronik (BIO, n = 72) was 33 +/- 10 months, for ELA Medical (ELA, n = 12) 44 +/- 17 months, for Guidant (GDT, n = 36) 49 +/- 12 months, for Medtronic (MDT, n = 29) 62 +/- 22 months, and for St. Jude Medical (SJM, n = 5) 31 +/- 9 months (P < 0.001). CONCLUSION: SC ICD generators had a longer service time compared to DC and CRT-D systems. No influence of indication for ICD therapy and HO stimulation on generator longevity was observed in this study. MDT ICDs had the longest service time.
Authors:
Paul Knops; Dominic A M J Theuns; Jan C J Res; Luc Jordaens
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  32     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-02     Completed Date:  2009-12-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1276-85     Citation Subset:  IM    
Affiliation:
Erasmus Medical Center, Rotterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Arrhythmias, Cardiac / epidemiology*,  prevention & control*
Defibrillators, Implantable / utilization*
Device Removal / utilization*
Equipment Failure / statistics & numerical data*
Equipment Failure Analysis / methods*,  statistics & numerical data*
Female
Humans
Maintenance / utilization
Male
Middle Aged
Netherlands / epidemiology
Technology Assessment, Biomedical / methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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