Benefit of Implantable Cardioverter-Defibrillator Generator Replacement in a Primary Prevention Population-Based Cohort

JACC. Clinical Electrophysiology
Willy WengRatika Parkash

Abstract

This study investigated the benefit of an implantable cardioverter-defibrillator (ICD) generator replacement in patients who did not have an ongoing theoretical indication for ICD therapy at time of replacement. Primary prevention ICD therapy is known to reduce mortality in patients with cardiomyopathy and reduced left ventricular systolic function. The data describing outcomes after generator replacement are limited. This was a retrospective cohort study following patients implanted with primary prevention ICD therapy from 2002 until 2015 who subsequently received a generator replacement. Patients with an ongoing theoretical indication for ICD therapy were defined as either left ventricular ejection fraction ≤35% or having had prior appropriate ICD therapy. Outcomes were mortality, appropriate ICD therapy and shock, inappropriate shock, and device and lead complications. A total of 614 patients were identified; 173 (28.2%) underwent a generator replacement and were followed for a mean of 2.9 years after replacement; 144 (83.2%) had an ongoing theoretical indication. Patients with no ongoing theoretical indication (n = 29, 16.7%) had lower mortality (hazard ratio [HR]: 0.39, 95% confidence interval [CI]: 0.15-1.00; p = 0.0495),...Continue Reading

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Citations

Jan 14, 2020·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Killian J McCarthyDaniel B Kramer
Apr 8, 2021·Pacing and Clinical Electrophysiology : PACE·Liane A ArcinasWilliam F McIntyre

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