TY - JOUR
T1 - Early mortality after implantable cardioverter defibrillator
T2 - Incidence and associated factors
AU - DAI-PP Investigators
AU - Garcia, Rodrigue
AU - Boveda, Serge
AU - Defaye, Pascal
AU - Sadoul, Nicolas
AU - Narayanan, Kumar
AU - Perier, Marie-Cécile
AU - Klug, Didier
AU - Fauchier, Laurent
AU - Leclercq, Christophe
AU - Babuty, Dominique
AU - Bordachar, Pierre
AU - Gras, Daniel
AU - Deharo, Jean-Claude
AU - Piot, Olivier
AU - Providencia, Rui
AU - Marijon, Eloi
AU - Algalarrondo, Vincent
N1 - Copyright © 2019 Elsevier B.V. All rights reserved.
PY - 2020/2/15
Y1 - 2020/2/15
N2 - BACKGROUND: According to guidelines, implantable cardioverter defibrillator (ICD) candidates must have a "reasonable expectation of survival with a good functional status >1 year". Identifying risk for early mortality in ICD candidates could be challenging. We aimed to identify factors associated with a ≤1-year survival among patients implanted with ICDs.METHODS: The DAI-PP program was a multicenter, observational French study that included all patients who received a primary prevention ICD in the 2002-2012 period. Characteristics of patients who survived ≤1 year following the implantation were compared with those who survived >1 year, and predictors of early death determined.RESULTS: Out of the 5539 enrolled patients, survival status at 1 year was known for a total of 5,457, and overall 230 (4.2%) survived ≤1 year. Causes of death were similar in the two groups. Patients with ≤1-year survival had lower rates of appropriate (14 vs. 23%; P = 0.004) and inappropriate ICD therapies (2 vs. 7%; P = 0.009) than patients who lived >1 year after ICD implantation. In multivariate analysis, older age, higher NYHA class (≥III), and atrial fibrillation were significantly associated with ≤1-year survival. Presence of all 3 risk factors was associated with a cumulative 22.63% risk of death within 1 year after implantation.CONCLUSIONS: This is the largest study determining the factors predicting early mortality after ICD implantation. Patients dying within the first year had low ICD therapy rates. A combination of clinical factors could potentially identify patients at risk for early mortality to help improve selection of ICD candidates.
AB - BACKGROUND: According to guidelines, implantable cardioverter defibrillator (ICD) candidates must have a "reasonable expectation of survival with a good functional status >1 year". Identifying risk for early mortality in ICD candidates could be challenging. We aimed to identify factors associated with a ≤1-year survival among patients implanted with ICDs.METHODS: The DAI-PP program was a multicenter, observational French study that included all patients who received a primary prevention ICD in the 2002-2012 period. Characteristics of patients who survived ≤1 year following the implantation were compared with those who survived >1 year, and predictors of early death determined.RESULTS: Out of the 5539 enrolled patients, survival status at 1 year was known for a total of 5,457, and overall 230 (4.2%) survived ≤1 year. Causes of death were similar in the two groups. Patients with ≤1-year survival had lower rates of appropriate (14 vs. 23%; P = 0.004) and inappropriate ICD therapies (2 vs. 7%; P = 0.009) than patients who lived >1 year after ICD implantation. In multivariate analysis, older age, higher NYHA class (≥III), and atrial fibrillation were significantly associated with ≤1-year survival. Presence of all 3 risk factors was associated with a cumulative 22.63% risk of death within 1 year after implantation.CONCLUSIONS: This is the largest study determining the factors predicting early mortality after ICD implantation. Patients dying within the first year had low ICD therapy rates. A combination of clinical factors could potentially identify patients at risk for early mortality to help improve selection of ICD candidates.
KW - Age Factors
KW - Atrial Fibrillation/epidemiology
KW - Cause of Death
KW - Death, Sudden, Cardiac/prevention & control
KW - Defibrillators, Implantable/adverse effects
KW - Electric Countershock/instrumentation
KW - Female
KW - France/epidemiology
KW - Heart Failure/epidemiology
KW - Humans
KW - Male
KW - Middle Aged
KW - Prognosis
KW - Prosthesis Implantation/methods
KW - Risk Assessment
KW - Risk Factors
KW - Survival Analysis
KW - Tachycardia, Ventricular/mortality
UR - http://www.scopus.com/inward/record.url?scp=85075510324&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2019.09.033
DO - 10.1016/j.ijcard.2019.09.033
M3 - Article
C2 - 31753583
VL - 301
SP - 114
EP - 118
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -