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Survival After Secondary Prevention Implantable Cardioverter-Defibrillator Placement: An Analysis From the NCDR ICD Registry.

Publication ,  Journal Article
Katz, DF; Peterson, P; Borne, RT; Betz, J; Al-Khatib, SM; Varosy, PD; Wang, Y; Hsu, JC; Hoffmayer, KS; Kipp, RT; Hansen, CM; Turakhia, MP; Masoudi, FA
Published in: JACC Clin Electrophysiol
January 2017

OBJECTIVES: This study sought to define the characteristics and risks of death of patients receiving a physician-designated secondary prevention implantable cardioverter-defibrillator (ICD) in contemporary clinical practice. BACKGROUND: Data on utilization and outcomes of ICDs for the secondary prevention of sudden cardiac death (SCD) are limited. METHODS: Patients enrolled in the National Cardiovascular Data Registry's (NCDR) ICD Registry from 2006 to 2009 with a physician-designated secondary prevention indication for ICD implantation were identified and linked to the Social Security Death Master File. Those patients with a history either of tachycardic arrest or sustained ventricular tachycardia (SCD/VT) or of syncope without SCD/VT were included. Kaplan-Meier survival analysis was used to assess mortality. Cox proportional hazards survival modeling was used to assess the risk of death in these groups, adjusting for patient characteristics. RESULTS: In the study cohort of 46,685 patients (mean age 66 ± 14 years, 73.5% male, 85% white), 78% had SCD/VT and 22% had syncope. Overall mortality was 10.4% at 1 year and 16.4% at 2 years. Compared with patients having SCD/VT, the adjusted hazard of death at 1 year was lower in the patients having syncope (hazard ratio: 0.89; 95% confidence interval: 0.83 to 0.96) but was not significantly different by 2 years (hazard ratio: 0.96; 95% confidence interval: 0.90 to 1.01). CONCLUSIONS: Nearly 9 of 10 patients receiving a secondary prevention ICD in clinical practice are alive 1 year after implantation. The risk of death varies by indication and is highest among patients who survive SCD or sustained VT in the first year after device implantation.

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Published In

JACC Clin Electrophysiol

DOI

EISSN

2405-5018

Publication Date

January 2017

Volume

3

Issue

1

Start / End Page

20 / 28

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Secondary Prevention
  • Quality of Life
  • Practice Guidelines as Topic
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate
  • Humans
  • Female
  • Equipment Design
 

Citation

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MLA
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Katz, D. F., Peterson, P., Borne, R. T., Betz, J., Al-Khatib, S. M., Varosy, P. D., … Masoudi, F. A. (2017). Survival After Secondary Prevention Implantable Cardioverter-Defibrillator Placement: An Analysis From the NCDR ICD Registry. JACC Clin Electrophysiol, 3(1), 20–28. https://doi.org/10.1016/j.jacep.2016.06.001
Katz, David F., Pamela Peterson, Ryan T. Borne, Jarrod Betz, Sana M. Al-Khatib, Paul D. Varosy, Yongfei Wang, et al. “Survival After Secondary Prevention Implantable Cardioverter-Defibrillator Placement: An Analysis From the NCDR ICD Registry.JACC Clin Electrophysiol 3, no. 1 (January 2017): 20–28. https://doi.org/10.1016/j.jacep.2016.06.001.
Katz DF, Peterson P, Borne RT, Betz J, Al-Khatib SM, Varosy PD, et al. Survival After Secondary Prevention Implantable Cardioverter-Defibrillator Placement: An Analysis From the NCDR ICD Registry. JACC Clin Electrophysiol. 2017 Jan;3(1):20–8.
Katz, David F., et al. “Survival After Secondary Prevention Implantable Cardioverter-Defibrillator Placement: An Analysis From the NCDR ICD Registry.JACC Clin Electrophysiol, vol. 3, no. 1, Jan. 2017, pp. 20–28. Pubmed, doi:10.1016/j.jacep.2016.06.001.
Katz DF, Peterson P, Borne RT, Betz J, Al-Khatib SM, Varosy PD, Wang Y, Hsu JC, Hoffmayer KS, Kipp RT, Hansen CM, Turakhia MP, Masoudi FA. Survival After Secondary Prevention Implantable Cardioverter-Defibrillator Placement: An Analysis From the NCDR ICD Registry. JACC Clin Electrophysiol. 2017 Jan;3(1):20–28.
Journal cover image

Published In

JACC Clin Electrophysiol

DOI

EISSN

2405-5018

Publication Date

January 2017

Volume

3

Issue

1

Start / End Page

20 / 28

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Secondary Prevention
  • Quality of Life
  • Practice Guidelines as Topic
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate
  • Humans
  • Female
  • Equipment Design