Related Experiment Video

Updated: Dec 26, 2025

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

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A Population-Based Study of Device Eligibility, Use, and Reasons for Nonimplantation in Patients at Heart

Rochelle Bernier1, Jessica Ng2, Dat T Tran3

  • 1Mazankowski Alberta Heart Institute, University of Alberta, Division of Cardiology, Edmonton, Alberta, Canada.

CJC Open
|March 12, 2020
PubMed

Insights

Only one-third of eligible patients received an implantable cardioverter defibrillator (ICD). Poor documentation for ICD nonimplantation was noted, with patient preference being a common reason.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Public Health

Background:

  • Implantable cardioverter defibrillator (ICD) therapy is crucial for preventing sudden cardiac death.
  • Real-world data on primary prevention ICD eligibility and utilization rates are limited.
  • This study addresses the gap by examining ICD use in heart function clinic (HFC) patients.

Purpose of the Study:

  • To determine the proportion of patients in heart function clinics eligible for primary prevention ICD.
  • To assess the actual implantation rates among eligible patients.
  • To identify reasons for nonimplantation of ICDs.

Main Methods:

  • Retrospective analysis of 1239 patients from Alberta, Canada (2013-2015).
  • Eligibility assessed using 2008 ACCF/AHA/HRS, 2012 ACCF/AHA/HRS Focused Update, and 2013 CCS CRT guidelines.
  • Logistic regression identified predictors of nonimplantation.

Main Results:

  • 45% of patients met ICD eligibility criteria; only 36% received a device.
  • For 52% of nonrecipients, no reason for nonimplantation was documented.
  • Patient preference (48%), older age (>75 years), and cancer history predicted nonimplantation.

Conclusions:

  • A significant gap exists between ICD eligibility and implantation rates.
  • Documentation of reasons for nonimplantation is inadequate.
  • Patient preference and clinical factors influence ICD decisions.
Abstract

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