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• W2213366809 abstract "Based on the results of multiple randomized controlled trials (RCTs) demonstrating striking reductions in mortality, implantable cardioverter-defibrillators (ICDs) have clearly become an important tool for both primary and secondary prevention of sudden cardiac death among patients at high risk. Beyond the trials, however, contemporary “real-world” studies can provide important insights about the care and outcomes among patients outside of the trial populations. In the United States, the National Cardiovascular Data Registry (NCDR) ICD Registry has been used primarily to assess indications, periprocedural care, and short-term outcomes among patients undergoing ICD placement since its inception in 2006. Long-term outcomes in real-world populations with ICDs (especially those outside the United States) are poorly characterized. In this issue of HeartRhythm, Schmidt et al present the temporal trends associated with ICD implantation in Denmark using the Danish National Patient Register (DNPR), including longitudinal mortality spanning the years 2000 to 2012. The DNPR uses administrative data from Denmark’s single-payer health care system to create a nationwide data registry that has been used for a diverse body of health services analyses. Using Cox proportional hazards models and mortality rate ratios, the authors report comorbidityadjusted mortality among ICD recipients in the DNPR. Over this time period, 8460 patients received an ICD in a cumulative population of nearly 7,726,000 in Denmark, and implantation rates increased 5-fold during this period. The rate of ICD implantation increased most dramatically among older patients and those with greater burden of comorbidity. The authors found that cumulative survival was 76% at 5 years and 54% at 10 years with an ICD. Not surprisingly, mortality was highest among the patients with greater burden of comorbidity, particularly among patients with congestive heart failure (adjusted 5-year mortality rate ratio 1.88, 95% confidence interval 1.66–2.14)." @default.
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• W2213366809 date "2015-09-01" @default.
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• W2213366809 title "Optimal utilization of implantable cardioverter-defibrillators: Are we there yet?" @default.
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• W2213366809 doi "https://doi.org/10.1016/j.hrthm.2015.06.021" @default.
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