Significant differences in the expected versus observed longevity of implantable cardioverter defibrillators (ICDs)

Tali Shafat, Yael Baumfeld, Victor Novack, Yuval Konstantino, Guy Amit

    Research output: Contribution to journalArticlepeer-review

    12 Scopus citations

    Abstract

    Background: Implantable cardioverter defibrillator (ICD) is a life-saving therapy for patients at risk of ventricular arrhythmias. Due to its high cost, its cost-effectiveness is highly dependent on its longevity, which is currently only based upon the manufacturer's predicted device life span. Aim: We sought to assess the ICDs' longevity and the factors influencing it, and to compare the observed (real life) to the expected (manufacturer's prediction) life span at a device level. Methods: We retrospectively identified all patients who underwent an ICD implantation in a tertiary care medical center. For each device, an expected longevity was assigned based on the manufacturer/model, pacing percentage, and number of shocks per year. We defined device failure if the observed survival was shorter than 80 % of the expected. Only devices with follow-up time that exceeded the expected longevity were included. Results: Of the 275 devices in the cohort, 79 (29 %) failed. Median device longevity was 5 years and varied markedly between manufacturers (4.3, 4.8, 5.1, and 6.3 years for Biotronik, St. Jude Medical, Boston Scientific, and Medtronic, respectively). There were significant differences among the manufacturers in device failure rates: 48, 17, 22, and 14 % for Biotronik, St. Jude Medical, Boston Scientific, and Medtronic, respectively). In multivariate analysis, manufacturer, earlier year of implantation, congestive heart failure and chronic renal failure significantly predicted device failure. Conclusions: In conclusion, there is a significant device failure rate among ICDs, with variability among manufacturers, impacting both patients and the medical economic systems.

    Original languageEnglish
    Pages (from-to)43-49
    Number of pages7
    JournalClinical Research in Cardiology
    Volume102
    Issue number1
    DOIs
    StatePublished - 1 Jan 2013

    Keywords

    • Battery performance
    • Device failure
    • Implantable cardioverter defibrillator
    • Longevity

    ASJC Scopus subject areas

    • Cardiology and Cardiovascular Medicine

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