Περίληψη:
Background: Manufacturers of implantable cardioverter-defibrillators
(ICDs) promise a 5- to 9-year projected longevity; however, real-life
data indicate otherwise. The aim of the present study was to assess ICD
longevity among 685 consecutive patients over the last 20 years.
Hypothesis: Real-life longevity of ICDs may differ from that stated by
the manufacturers.
Methods: The study included 601 men and 84 women (mean age, 63.1 +/-
13.3 years). The underlying disease was coronary (n = 396) or valvular
(n = 15) disease, cardiomyopathy (n = 220), or electrical disease (n =
54). The mean ejection fraction was 35%. Devices were implanted for
secondary (n = 562) or primary (n = 123) prevention. Single- (n = 292)
or dual-chamber (n = 269) or cardiac resynchronization therapy (CRT)
devices (n = 124) were implanted in the abdomen (n = 17) or chest (n =
668).
Results: Over 20 years, ICD pulse generator replacements were performed
in 238 patients (209 men; age 63.7 +/- 13.9 years; ejection fraction,
37.7% +/- 14.0%) who had an ICD for secondary (n = 210) or primary (n
= 28) prevention. The mean ICD longevity was 58.3 +/- 18.7 months. In 20
(8.4%) patients, devices exhibited premature battery depletion within
36 months. Most (94%) patients had none, minor, or modest use of ICD
therapy. Longevity was longest for single-chamber devices and shortest
for CRT devices. Latest-generation devices replaced over the second
decade lasted longer compared with devices replaced during the first
decade. When analyzed by manufacturer, Medtronic devices appeared to
have longer longevity by 13 to 18 months.
Conclusions: ICDs continue to have limited longevity of 4.9 +/- 1.6
years, and 8% demonstrate premature battery depletion by 3 years. CRT
devices have the shortest longevity (mean, 3.8 years) by 13 to 17
months, compared with other ICD devices. These findings have important
implications, particularly in view of the high expense involved with
this type of electrical therapy.
Συγγραφείς:
Manolis, Antonis S.
Maounis, Themistoklis
Koulouris, Spyridon
and Vassilikos, Vassilios
