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. 2022 Jan;8(1):88-100.
doi: 10.1016/j.jacep.2021.06.006. Epub 2021 Aug 25.

Trends in Cardiovascular Implantable Electronic Device Insertion Between 1988 and 2018 in Olmsted County

Vaibhav R Vaidya  1 , Roshini Asirvatham  1 , Gurukripa N Kowlgi  1 , Ming-Yan Dai  2 , Jordan J Cochuyt  3 , David O Hodge  3 , Abhishek J Deshmukh  1 , Yong Mei Cha  4
Affiliations

Trends in Cardiovascular Implantable Electronic Device Insertion Between 1988 and 2018 in Olmsted County

Vaibhav R Vaidya et al. JACC Clin Electrophysiol. 2022 Jan.

Abstract

Objectives: This study sought to describe trends in cardiovascular implantable electronic device (CIED) insertion over the past 3 decades in Olmsted County.

Background: Trends in CIED insertion in the United States have not been extensively studied.

Methods: The Rochester Epidemiology Project is a medical records linkage system comprising the records of all residents of Olmsted County from 1966 to the present. CIED insertion between 1988 and 2018 was determined using International Classification of Diseases-Ninth Revision, International Classification of Diseases-10th Revision, and Current Procedural Terminology codes. Age- and sex-adjusted incidence rates, adjusted to the 2010 US White population, were calculated. Trends in incidence over time, across age groups, and between sex are estimated using Poisson regression models.

Results: The age- and sex-adjusted incidence of device implants for the study period were as follows: overall CIED: 82.4 (95% CI: 79.2-85.6); permanent pacemaker (PPM): 62.9 (95% CI: 60.0-65.7); implantable cardioverter-defibrillator (ICD): 14.0 (95% CI: 12.6-15.3); and cardiac resynchronization therapy (CRT): 5.6 (95% CI: 4.7-6.4) per 100,000 per year. The overall incidence of CIED insertion increased between 1988 to 1993 and 2000 to 2005 and then decreased between 2000 to 2005 and 2012 to 218 (P < 0.0001). PPM and ICD insertion incidence followed these trends, whereas the incidence of CRT insertion increased between 2000 to 2005 and 2012 to 2018. CIED insertion incidence increased with age (P < 0.0001). CIED insertion incidence was greater in men (116.3 vs 57.3 per 100,000 per year in men vs women; P < 0.0001). The overall survival of CRT recipients improved (P = 0.0044).

Conclusions: The incidence values for PPM and ICD implants are decreasing, while the incidence of CRT implants is increasing. CIEDs are increasingly inserted in the elderly, men, and patients with higher comorbidities.

Keywords: cardiac pacemaker; cardiovascular implantable electronic devices; epidemiology; implantable cardioverter-defibrillator; resynchronization therapy.

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Conflict of interest statement

Funding Support and Author Disclosures This study was made possible using the resources of the REP, which is supported by the National Institute on Aging of the National Institutes of Health under award number R01AG034676. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The study was supported by funding from the Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

FIGURE 1
FIGURE 1
Trends in CIED Insertion in Olmsted County
FIGURE 1
FIGURE 1
Trends in CIED Insertion in Olmsted County
FIGURE 2
FIGURE 2
Age- and Sex-Adjusted Incidence of CIED Insertion
FIGURE 2
FIGURE 2
Age- and Sex-Adjusted Incidence of CIED Insertion
FIGURE 2
FIGURE 2
Age- and Sex-Adjusted Incidence of CIED Insertion
FIGURE 2
FIGURE 2
Age- and Sex-Adjusted Incidence of CIED Insertion
FIGURE 3
FIGURE 3
Mortality After Device Insertion
FIGURE 3
FIGURE 3
Mortality After Device Insertion
FIGURE 3
FIGURE 3
Mortality After Device Insertion
FIGURE 4
FIGURE 4
Survival After Device Implantation by Sex
FIGURE 4
FIGURE 4
Survival After Device Implantation by Sex
FIGURE 4
FIGURE 4
Survival After Device Implantation by Sex
FIGURE 4
FIGURE 4
Survival After Device Implantation by Sex
Central Illustration:
Central Illustration:
Trends in Cardiovascular Implantable Electronic Device Implantation in Olmsted County
See this image and copyright information in PMC

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