Variability in implantable cardioverter-defibrillator battery longevity

Area of Science:

• Cardiology
• Biomedical Engineering
• Medical Device Technology

Background:

• Implantable cardioverter-defibrillator (ICD) battery life directly affects generator replacement frequency, influencing patient risk and healthcare costs.
• Optimizing ICD battery longevity is crucial for reducing complications and managing economic burdens associated with device replacement.

Purpose of the Study:

• To identify key factors influencing the battery longevity of implantable cardioverter-defibrillators (ICDs).
• To compare the battery longevity performance across different ICD manufacturers.

Main Methods:

• Analysis of a nationwide, multicenter remote monitoring dataset (PaceMate) for ICDs implanted between 2003 and 2023.
• Comparison of Kaplan-Meier survival curves and device parameters across manufacturers, evaluating time to replacement interval (RI).
• Cox regression analysis to determine the impact of device type, manufacturer, and programmed parameters on battery longevity.

Main Results:

• Each additional lead decreased ICD battery longevity by approximately 2-3 years.
• Boston Scientific transvenous ICDs demonstrated the longest battery longevity across single-, dual-, and biventricular types.
• ICDs implanted in the last 2 years showed a 2-4 year improvement in estimated longevity compared to older devices.

Conclusions:

• ICD battery longevity significantly varies by device type and manufacturer, with newer devices offering substantially longer lifespans.
• Manufacturer, programmed pulse width, and programmed output are the primary determinants of ICD battery longevity.
• Understanding these factors can guide clinical decisions and improve patient outcomes by optimizing device selection and programming.