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Published on: February 28, 2012
Implantable cardioverter-defibrillator longevity under clinical circumstances: an analysis according to device type,
Joep Thijssen1, C Jan Willem Borleffs, Johannes B van Rees
1Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
Insights
The majority of implantable cardioverter-defibrillators (ICDs) are replaced due to battery depletion, with average battery longevity of 5.5 years. Newer ICD generations and certain manufacturers show improved battery life.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Device Technology
Background:
- Implantable cardioverter-defibrillator (ICD) treatment is limited by device service life.
- Data on ICD longevity in clinical settings are scarce.
- This study evaluates ICD service life in a large patient cohort.
Purpose of the Study:
- To assess the battery longevity of implantable cardioverter-defibrillators (ICDs) under real-world clinical conditions.
- To identify factors influencing ICD battery lifespan.
Main Methods:
- Analysis of 4673 ICD implantations from 1996 onwards.
- Categorization of ICD replacements into battery depletion and non-battery depletion.
- Calculation of device and battery longevity, assessing impact of device type, generation, manufacturer, pacing, and shocks.
Main Results:
- 72% of 1479 ICD replacements were due to battery depletion, with a mean battery longevity of 5.5 years.
- Battery longevity varied significantly by ICD type (CRT-Ds shorter) and manufacturer.
- Devices implanted after 2002 exhibited improved battery longevity compared to older models.
Conclusions:
- Battery depletion is the primary reason for ICD replacement.
- Significant variations in ICD battery longevity exist across device types and manufacturers.
- Modern implantable cardioverter-defibrillator generations demonstrate enhanced battery performance.
Background:
One of the major drawbacks of implantable cardioverter-defibrillator (ICD) treatment is the limited device service life. Thus far, data concerning ICD longevity under clinical circumstances are scarce. In this study, the ICD service life was assessed in a large cohort of ICD recipients.
Objective:
To assess the battery longevity of ICDs under clinical circumstances.
Methods:
All patients receiving an ICD in the Leiden University Medical Center were included in the analysis. During prospectively recorded follow-up visits, reasons for ICD replacement were assessed and categorized as battery depletion and non-battery depletion. Device longevity and battery longevity were calculated. The impact of device type, generation, manufacturer, the percentage of pacing, the pacing output, and the number of shocks on the battery longevity was assessed.
Results:
Since 1996, 4673 ICDs were implanted, of which 1479 ICDs (33%) were replaced. Mean device longevity was 5.0 ± 0.1 years. A total of 1072 (72%) ICDs were replaced because of battery depletion. Mean battery longevity of an ICD was 5.5 ± 0.1 years. When divided into different types, mean battery longevity was 5.5 ± 0.2 years for single-chamber ICDs, 5.8 ± 0.1 for dual-chamber ICDs, and 4.7 ± 0.1 years for cardiac resynchronization therapy-defibrillators (P <.001). Devices implanted after 2002 had a significantly better battery longevity as compared with devices implanted before 2002 (5.6 ± 0.1 years vs 4.9 ± 0.2 years; P <.001). In addition, large differences in battery longevity between manufacturers were noted (overall log-rank test, P <.001).
Conclusions:
The majority of ICDs were replaced because of battery depletion. Large differences in longevity exist between different ICD types and manufacturers. Modern ICD generations demonstrated improved longevity.
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