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Implantable Cardioverter-defibrillator Utilization and Its Outcomes in Korea: Data from Korean Acute Heart Failure

Youngjin Cho1, Sang Yeong Cho1, Il Young Oh1

  • 1Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.

Journal of Korean Medical Science
|December 1, 2020
PubMed

Insights

Implantable cardioverter-defibrillators (ICDs) are under-utilized in Korean heart failure patients with reduced ejection fraction. However, ICD use was associated with significantly lower mortality, suggesting a survival benefit in this population.

Area of Science:

  • Cardiology
  • Medical Devices
  • Public Health

Background:

  • Limited data exists on implantable cardioverter-defibrillator (ICD) utilization and benefits in Korean patients with heart failure and reduced left ventricular ejection fraction (LVEF).
  • A multicenter registry study was conducted to address this data gap.

Purpose of the Study:

  • To evaluate the utilization rate of ICDs in Korean patients with heart failure and reduced LVEF.
  • To assess the impact of ICD implantation on all-cause mortality in this patient group.

Main Methods:

  • A cohort of 485 acute heart failure patients with LVEF ≤ 35% was identified from 10 Korean tertiary hospitals.
  • ICD implantation during follow-up was assessed, and mortality was compared between ICD recipients and matched controls.

Main Results:

  • Only 11.5% of eligible patients received an ICD, indicating significant under-utilization.
  • Patients with ICDs demonstrated significantly lower all-cause mortality compared to controls (adjusted HR = 0.39; P = 0.032).
  • This survival benefit persisted after excluding patients with cardiac resynchronization therapy and was particularly notable in ischemic heart failure.

Conclusions:

  • The study highlights a substantial under-utilization of ICDs in Korean heart failure patients with reduced LVEF.
  • Findings suggest that the survival benefits of ICDs observed in clinical trials can likely be extrapolated to the Korean population.
  • Further research and clinical practice adjustments are warranted to optimize ICD use in this demographic.
Abstract

Keywords:
Heart FailureImplantable Cardioverter-defibrillator

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