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Analysis of implantable defibrillator longevity under clinical circumstances : implications for device selection

Author
Organization
Abstract
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.
Keywords
longevity, device selection, replacement, implantable cardioverter defibrillator, CHAMBER CARDIOVERTER-DEFIBRILLATORS, CHRONIC HEART-FAILURE, ANTIARRHYTHMIC-DRUG THERAPY, SUDDEN CARDIAC DEATH, TERM-FOLLOW-UP, DUAL-CHAMBER, SINGLE-CHAMBER, SUPRAVENTRICULAR TACHYCARDIA, INAPPROPRIATE THERAPY, MYOCARDIAL-INFARCTION

Citation

Please use this url to cite or link to this publication:

MLA
Knops, Paul et al. “Analysis of Implantable Defibrillator Longevity Under Clinical Circumstances : Implications for Device Selection.” PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY 32.10 (2009): 1276–1285. Print.
APA
Knops, P., Theuns, D. A., Res, J. C., & Jordaens, L. (2009). Analysis of implantable defibrillator longevity under clinical circumstances : implications for device selection. PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, 32(10), 1276–1285.
Chicago author-date
Knops, Paul, Dominic AMJ Theuns, Jan CJ Res, and Luc Jordaens. 2009. “Analysis of Implantable Defibrillator Longevity Under Clinical Circumstances : Implications for Device Selection.” Pace-pacing and Clinical Electrophysiology 32 (10): 1276–1285.
Chicago author-date (all authors)
Knops, Paul, Dominic AMJ Theuns, Jan CJ Res, and Luc Jordaens. 2009. “Analysis of Implantable Defibrillator Longevity Under Clinical Circumstances : Implications for Device Selection.” Pace-pacing and Clinical Electrophysiology 32 (10): 1276–1285.
Vancouver
1.
Knops P, Theuns DA, Res JC, Jordaens L. Analysis of implantable defibrillator longevity under clinical circumstances : implications for device selection. PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY. 2009;32(10):1276–85.
IEEE
[1]
P. Knops, D. A. Theuns, J. C. Res, and L. Jordaens, “Analysis of implantable defibrillator longevity under clinical circumstances : implications for device selection,” PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY, vol. 32, no. 10, pp. 1276–1285, 2009.
@article{8151404,
  abstract     = {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.},
  author       = {Knops, Paul and Theuns, Dominic AMJ and Res, Jan CJ and Jordaens, Luc},
  issn         = {0147-8389},
  journal      = {PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY},
  keywords     = {longevity,device selection,replacement,implantable cardioverter defibrillator,CHAMBER CARDIOVERTER-DEFIBRILLATORS,CHRONIC HEART-FAILURE,ANTIARRHYTHMIC-DRUG THERAPY,SUDDEN CARDIAC DEATH,TERM-FOLLOW-UP,DUAL-CHAMBER,SINGLE-CHAMBER,SUPRAVENTRICULAR TACHYCARDIA,INAPPROPRIATE THERAPY,MYOCARDIAL-INFARCTION},
  language     = {eng},
  number       = {10},
  pages        = {1276--1285},
  title        = {Analysis of implantable defibrillator longevity under clinical circumstances : implications for device selection},
  url          = {http://dx.doi.org/10.1111/j.1540-8159.2009.02482.x},
  volume       = {32},
  year         = {2009},
}

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