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Type: Journal article
Title: Predicted longevity of contemporary cardiac implantable electronic devices: a call for industry-wide “standardized” reporting
Author: Munawar, D.
Mahajan, R.
Linz, D.
Wong, G.
Khokhar, K.
Thiyagarajah, A.
Kadhim, K.
Emami, M.
Mishima, R.
Elliott, A.
Middeldorp, M.
Roberts-Thompson, K.
Young, G.
Sanders, P.
Lau, D.
Citation: Heart Rhythm, 2018; 15(12):1756-1763
Publisher: Elsevier
Issue Date: 2018
ISSN: 1547-5271
Statement of
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
Rights: © 2018 Heart Rhythm Society. All rights reserved.
DOI: 10.1016/j.hrthm.2018.07.029
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