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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
16:40

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation

Published on: February 28, 2012

Implantable cardioverter-defibrillators in patients hospitalized for heart failure with chronically reduced left

Norman C Wang1, Jonathan P Piccini, Marvin A Konstam

  • 1University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

American Journal of Therapeutics
|July 17, 2010
PubMed

Insights

Patients with an implantable cardioverter-defibrillator (ICD) hospitalized for heart failure (HF) had similar mortality but higher HF rehospitalization rates. Further research should explore ICD care optimization and implantation timing for HF patients.

Area of Science:

  • Cardiology
  • Medical Devices
  • Heart Failure Management

Background:

  • Worsening heart failure (HF) in patients with reduced left ventricular ejection fraction (LVEF ≤ 40%) is a significant clinical challenge.
  • The role of implantable cardioverter-defibrillators (ICDs) in this population during acute HF exacerbations requires further investigation.

Purpose of the Study:

  • To examine the association between ICD status at hospitalization for worsening HF and post-discharge outcomes.
  • To compare all-cause mortality and HF rehospitalization rates in patients with and without an ICD.

Main Methods:

  • Analysis of 4133 patients hospitalized for HF with LVEF ≤ 40% from the EVEREST registry.
  • Comparison of outcomes between patients with an ICD (n=600) and those without an electrophysiological device (n=3102).
  • Median follow-up of 300 days, with adjusted analyses for multiple variables.

Main Results:

  • Unadjusted analysis showed higher mortality and HF rehospitalization in the ICD group.
  • After adjustment, all-cause mortality rates were similar between groups (HR, 1.01; 95% CI, 0.83-1.22).
  • Adjusted analyses revealed significantly higher rates of HF rehospitalization in the ICD group (HR, 1.35; 95% CI, 1.14-1.60).

Conclusions:

  • In patients with reduced LVEF, having an ICD at the time of HF hospitalization was linked to similar mortality but increased HF rehospitalization.
  • Findings suggest a need to investigate optimizing care for existing ICD patients and the role of ICD implantation during or after HF hospitalization.

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