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. 2019 Oct 6;36(1):153-163.
doi: 10.1002/joa3.12244. eCollection 2020 Feb.

Implantable cardioverter defibrillator and cardiac resynchronization therapy use in New Zealand (ANZACS-QI 33)

Fang Shawn Foo  1   2 , Mildred Lee  1   3 , Khang-Li Looi  2 , Peter Larsen  4 , Geoffrey C Clare  5   6 , David Heaven  1 , Martin K Stiles  7 , Jamie Voss  1 , Dean Boddington  8 , Rod Jackson  3 , Andrew J Kerr  1   3 ; ANZACS‐QI investigators
Collaborators, Affiliations

Implantable cardioverter defibrillator and cardiac resynchronization therapy use in New Zealand (ANZACS-QI 33)

Fang Shawn Foo et al. J Arrhythm. .

Abstract

Background: The ANZACS-QI Cardiac Implanted Device Registry (ANZACS-QI DEVICE) collects nationwide data on cardiac implantable electronic devices in New Zealand (NZ). We used the registry to describe contemporary NZ use of implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy (CRT).

Methods: All ICD and CRT Pacemaker implants recorded in ANZACS-QI DEVICE between 1 January 2014 and 31 December 2017 were analyzed.

Results: Of 1579 ICD implants, 1152 (73.0%) were new implants, including 49.0% for primary prevention and 51.0% for secondary prevention. In both groups, median age was 62 years and patients were predominantly male (81.4% and 79.2%, respectively). Most patients receiving a primary prevention ICD had a history of clinical heart failure (80.4%), NYHA class II-III symptoms (77.1%) and LVEF ≤35% (96.9%). In the secondary prevention ICD cohort, 88.4% were for sustained ventricular tachycardia or survived cardiac arrest from ventricular arrhythmia. Compared to primary prevention CRT Defibrillators (n = 155), those receiving CRT Pacemakers (n = 175) were older (median age 74 vs 66 years) and more likely to be female (38.3% vs 19.4%). Of the 427 (27.0%) ICD replacements (mean duration 6.3 years), 46.6% had received appropriate device therapy while 17.8% received inappropriate therapy. The ICD implant rate was 119 per million population with regional variation in implant rates, ratio of primary prevention ICD implants, and selection of CRT modality.

Conclusion: In contemporary NZ practice three-quarters of ICD implants were new implants, of which half were for primary prevention. The majority met current guideline indications. Patients receiving CRT pacemaker were older and more likely to be female.

Keywords: Implantable cardioverter defibrillator; New Zealand; cardiac resynchronization therapy; device therapy; implant rates.

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Conflict of interest statement

The authors declare no conflict of interests for this article.

Figures

Figure 1
Figure 1
Regional variation in ICD and CRT implant rate per million population in 2016. ICD, implantable cardioverter defibrillator; CRT, cardiac resynchronisation therapy
Figure 2
Figure 2
Regional variation in new primary prevention to secondary prevention ICD implant ratio in 2016. ICD, implantable cardioverter defibrillator
See this image and copyright information in PMC

References

    1. Ponikowski P, Voors AA, Anker SD,Bueno H, Cleland J, Coats A, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2016;37(27):2129–200. - PubMed
    1. Buxton AE, Lee KL, Fisher JD, Josephson ME, Prystowsky EN, Hafley G. A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators. N Engl J Med. 1999;341(25):1882–90. - PubMed
    1. Moss AJ, Zareba W, Hall WJ, Klein H, Wilber DJ, Cannom DS, et al. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med. 2002;346(12):877–83. - PubMed
    1. Kadish A, Dyer A, Daubert JP, Quigg R, Estes N, Anderson KP, et al. Prophylactic defibrillator implantation in patients with nonischemic dilated cardiomyopathy. N Engl J Med. 2004;350(21):2151–8. - PubMed
    1. Hohnloser SH, Kuck KH, Dorian P, Roberts RS, Hampton JR, Hatala R, et al. Prophylactic use of an implantable cardioverter‐defibrillator after acute myocardial infarction. N Engl J Med. 2004;351(24):2481–8. - PubMed