Post-defibrillation survival: a measure of ICD and CRT-D effectiveness
E Sathialingam, L Sabet, K Ryu, R CorbisieroAbstract
Background
Implantable cardioverter defibrillators (ICDs) and cardiac resynchronization therapy defibrillators (CRT-Ds) have revolutionized the management of life-threatening ventricular arrhythmias, becoming a cornerstone in the prevention of sudden cardiac death. These implanted devices use advanced arrhythmia detection algorithms to continuously identify abnormal rhythms and restore normal sinus rhythm through high-energy shocks.
Purpose
This study evaluated the impact of ICDs and CRT-Ds on extending patient life expectancy.
Methods
Patients were implanted with a variety of ICDs and CRT-Ds (Ellipse, Fortify, Entrant, Gallant, Neutrino, Quadra Assura, Unify Assura, Fortify Assura). Patients were included only if they had experienced at least one defibrillation shock since implant and had more than one post-shock transmission. For each patient, implant date, first defibrillation shock, and last transmission were recorded.
Results
23,853 US-based patients who were implanted with ICDs and CRT-Ds (26% single-chamber ICD, 42% dual-chamber ICD, 32% CRT-D) and were enrolled in Merlin.net all received at least one defibrillation therapy. The times from implant to the last recorded transmission averaged 2091±210 days and 1898±978 days for ICDs and CRT-Ds, respectively. The mean times from implant to first defibrillation shock were 836±100 days for ICDs and 761±805 days for CRT-Ds. Finally, the mean times from first shock to last transmission representing life extension for this patient cohort was 1255±110 days and 1137±844 days for ICDs and CRT-Ds, respectively.
Conclusion
This study highlights the life-extending impact of ICD/CRT-D therapy in patients implanted with these devices. The observed life prolongment underscores the effectiveness of ICDs/CRT-Ds in preventing sudden cardiac death through timely defibrillation. These findings reinforce the critical role of ICDs/CRT-Ds in reducing mortality and improving the long-term outcomes in these cardiac patients.