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Longevity Matters

Where are we today?

Patients implanted today with an ICD or CRT-D are younger and younger. This is due to progressively widened ICD indications as well as a preference for performing implants in patients with better life expectancy.

The same is also true for CRT patients. Ever since CRT recommendations were extended to include mildly symptomatic patients, patients have started to be implanted at an earlier stage in their disease which is why today we see that patients are living with their devices for much longer periods of time than before.

Over

60%

of implants take place in patients less than 70 years old.1

More than

30%

of patients need at least one replacement for battery depletion.2

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There is a need to solve the mismatch between patient life expectancy & device longevity.

ICD and CRT-D patients exhibit long term survival benefits following device implant. Therefore, almost one third of the patients undergo device replacement due to battery depletion.

Patient life expectancy versus ICD/CRT-D longevity

Complications with Replacement

Sooner or later, the issue of replacement arises and brings with it risks of serious complications.

Avoid Risky Replacements

Replacement procedures are associated with:

2x

occurrences of surgical reinterventions
for infections or other causes.3

5 fold

increase ICD lead issues.4

First surgical re-intervention after replacement versus after de novo implant.

Device replacement is a short procedure but with serious outcomes. The risk of complications is twice as high at reintervention than at first implant.3

ICD lead alerts after generator replacement compared to controls with leads of the same age without generator replacement.

Lead malfunction is an important cause of morbidity and mortality in patients with an ICD and the failure of high-voltage leads significantly increases after ICD generator replacement. In fact, replacement leads to a five-fold increase of ICD lead issues. Avoiding device replacement limits the risk of ICD lead failure.4

Hear what the experts are saying

1.

Swedish ICD and Pacemaker Registry – Annual statistic report 2014. https://www. pacemakerregistret.se/icdpmr/start.do.

2.

Ramachandra I. Impact of ICD battery Longevity on Need for Device Replacements Insight from Veterans Affairs Database. PACE 2010; 33:314-319.

3.

Borleffs CJW, Thijssen J, Mihaly K et al. Recurrent Implantable Cardioverter Defibrillator Replacement Is Associated with Increasing Risk of Pocket-Related Complications. Pacing Clinical electrophysiology 2013;33:1013-19. 10.

4.

Lovelock JD, Cruz C, Hoskins MH et al. Generator replacement is associated with an increased rate of ICD alerts. Heart Rhythm 2014;11(10):1785-89.

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