Early mortality after implantable cardioverter defibrillator: Incidence and associated factors

DAI-PP Investigators, Rodrigue Garcia, Serge Boveda, Pascal Defaye, Nicolas Sadoul, Kumar Narayanan, Marie-Cécile Perier, Didier Klug, Laurent Fauchier, Christophe Leclercq, Dominique Babuty, Pierre Bordachar, Daniel Gras, Jean-Claude Deharo, Olivier Piot, Rui Providencia, Eloi Marijon, Vincent Algalarrondo

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)114-118
Number of pages5
JournalInternational Journal of Cardiology
Publication statusPublished - 15 Feb 2020

Bibliographical note

Copyright © 2019 Elsevier B.V. All rights reserved.


  • Age Factors
  • Atrial Fibrillation/epidemiology
  • Cause of Death
  • Death, Sudden, Cardiac/prevention & control
  • Defibrillators, Implantable/adverse effects
  • Electric Countershock/instrumentation
  • Female
  • France/epidemiology
  • Heart Failure/epidemiology
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Prosthesis Implantation/methods
  • Risk Assessment
  • Risk Factors
  • Survival Analysis
  • Tachycardia, Ventricular/mortality


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