Mortality Benefit Among Primary Prevention Implantable Cardioverter-Defibrillator Recipients on Contemporary...

Area of Science:

• Cardiology
• Medical Devices
• Public Health

Background:

• Previous trials established implantable cardioverter-defibrillators (ICDs) efficacy in preventing sudden cardiac death.
• Evolving heart failure management and ICD technology necessitate updated mortality benefit assessments.

Purpose of the Study:

• To evaluate mortality rates in patients with a primary prevention (PP) indication for an ICD.
• To compare outcomes between patients who received an ICD versus those who did not, using contemporary real-world data.

Main Methods:

• Utilized a large US electronic health record dataset (2012-2020).
• Included patients with a PP indication for ICD who survived at least one year post-indication.
• Employed propensity matching to ensure comparable groups for analysis.

Main Results:

• 25,296 patients identified with a PP ICD indication; 8.4% received an ICD within a year.
• Propensity-matched analysis revealed a 24.3% lower risk of all-cause mortality in patients treated with an ICD (HR: 0.757).
• No significant difference in ICD benefit was observed between ischemic and non-ischemic heart disease patients.

Conclusions:

• ICD treatment for primary prevention is associated with improved patient survival.
• This benefit persists despite advancements in adjunctive heart failure therapies.
• Findings align with and reinforce conclusions from earlier landmark clinical trials.