HRS.14: CRT-D longevity varies across device makers

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 - ecg, heart, electrophysiology

The longevity of some implantable cardiac devices can vary greatly by manufacturer, according to a Danish study presented May 8 at the Heart Rhythm Society scientific session in San Francisco. The study showed Medtronic with the highest rate of battery depletion or device failure.

Jens B. Johansen, MD, PhD, of Odense University Hospital in Odense, Denmark, and colleagues compared the longevity of cardiac resynchronization therapy-defibrillators (CRT-Ds) implanted in patients in Denmark between 2007 to Oct. 31, 2013. They used the Danish Implantable Cardioverter-Defibrillator Registry, a comprehensive database that captures data such as patient demographics, patient survival, device serial number, shock incidence and explants.

They measured the time to exchange of the device when either the battery had become depleted or the device failed. The study did not include patients whose devices were removed for other reasons or who died.

“We wanted to look at a contemporary portfolio,” Johansen told Cardiovascular Business. “It is only products that were put on the market after 2007.”

The final sample included 1,587 CRT-Ds by St. Jude Medical, 651 by Medtronic, 369 by Biotronik and 136 by Boston Scientific. Medtronic had the highest rate of battery depletion or failure, at 6.7 percent, followed by St. Jude Medical (2.1 percent), Biotronik (1.1 percent) and Boston Scientific (0.7 percent).

Battery depletion was the most common reason for an exchange. Medtronic also had the lowest four-year survival rate at 81.1 percent, followed by St. Jude Medical (93.6 percent), Boston Scientific (95.7 percent) and Biotronik (95.8 percent).   

“The findings may also apply to other countries,” Johansen said, given that the various CRT-D devices assessed in their study are approved for use outside Denmark as well. He added the results support findings from single-center studies that identified variation in device longevity.

The Danish researchers will use the findings to work with manufacturers to improve device longevity. Johansen pointed out that longevity is not only a matter of resource use but also patient safety because explanting a device may expose the patient to complications such as infections.