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|Title:||Predicted longevity of contemporary cardiac implantable electronic devices: a call for industry-wide “standardized” reporting|
|Citation:||Heart Rhythm, 2018; 15(12):1756-1763|
|Dian A. Munawar, Rajiv Mahajan, Dominik Linz, Geoffrey R.Wong, Kashif B.Khokhar, Anand Thiyagarajah, Kadhim Kadhim, Mehrdad Emami, Ricardo Mishima, Adrian D.Elliott, Melissa E.Middeldorp, Kurt C.Roberts-Thompson, Glenn D.Young, Prashanthan Sanders, Dennis H.Lau|
|Abstract:||Background: Battery longevity is an important factor that may influence the selection of cardiac implantable electronic devices (CIEDs). However, there remains a lack of industry-wide standardized reporting of predicted CIED longevity to facilitate informed decision-making for implanting physicians and payers. Objective: The purpose of this study was to compare the predicted longevity of current generation CIEDs using best-matched CIEDs settings to assess differences between brands and models. Methods: Data were extracted for current model pacemakers, implantable cardioverter–defibrillators (ICDs), and cardiac resynchronization therapy–defibrillators (CRT-Ds) from product manuals and, where absent, by communication with the manufacturers. Pacemaker longevity estimations were based on standardized pacing outputs (2.5V, 0.40-ms pulse width, 500-Ω impedance) and pacing loads of 50% or 100% at 60 bpm. ICD and CRT-D longevity were estimated at 0% pacing and 15% atrial plus 100% biventricular pacing, with essential capacitor reforms and zero clinical shocks. Results: Mean maximum predicted longevity of single- and dual-chamber pacemakers was 12.0 ± 2.1 and 9.8 ± 1.9 years, respectively. Use of advanced features such as remote monitoring, prearrhythmia electrogram storage, and rate response can result in ∼1.4 years of reduction in longevity. Mean maximum predicted longevity of ICDs and CRT-Ds was 12.4 ± 3.0 and 8.8 ± 2.1 years, respectively. Of note, there were significant variations in predicted CIED longevity according to device manufacturers, with up to 44%, 42%, and 44% difference for pacemakers, ICDs, and CRT-Ds, respectively. Conclusion: Contemporary CIEDs demonstrate highly variable predicted longevity according to device manufacturers. This may impact on health care costs and long-term clinical outcomes.|
|Keywords:||Battery longevity; Cardiac implantable electronic device; Cardiac resynchronization therapy; Implantable cardioverter-defibrillator; Pacemaker|
|Rights:||© 2018 Heart Rhythm Society. All rights reserved.|
|Appears in Collections:||Medicine publications|
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