PP54 A Cohort Case Study On Implantable Cardioverter Defibrillators

• Published in: International journal of technology assessment in health care 2019, Vol.35 (S1), p.47-47
• Main Authors: Soares dos Santos, Augusto Cesar, Horta, Maria da Glória Cruvinel, Fernandes, Mariana, Rodrigues, Luíza, Carvalho, Lélia Maria de Almeida, Avelar, Sandra de Oliveira Sapori, Pinto, Elen Cristina, Scherrer, Luciano Rios, Biscione, Fernando Martin, Kelles, Silvana Marcia
• Format: Article
• Language: English
• Subjects: Arrhythmia; Cardiac arrhythmia; Case reports; Chemotherapy; Clinical trials; Continuity (mathematics); Defibrillators; Drug therapy; Model testing; Rank tests; Regression models; Survival; Transplants & implants; Ventricle
• ISSN: 0266-4623; 1471-6348
• DOI: 10.1017/S0266462319002083

Copyright © Cambridge University Press 20192019Cambridge University PressIntroductionMany patients presenting with arrhythmias are treated with antiarrhythmic drug therapy. However, for some patients, usually survivors of previous serious ventricular arrhythmias, treatment implies the use of implantable cardioverter defibrillators (ICDs) and/or Cardiac Resynchronization Therapy (CRT) devices.MethodsThis retrospective study evaluated a cohort of patients with arrhythmia requiring the use of ICDs, CRT or ICDs + CRT from January 2004 to March 2018. Data from a private healthcare organization in Belo Horizonte, Brazil were used to assess all-cause mortality and the need for replacement of the device. Continuous variables were expressed as mean and standard deviation. Cox proportional regression model and Log-Rank test were used to adjust the survival curve.ResultsFive hundred and ninety-three patients were included in the study (median age 67.6 years, range 23 to 89 years; male 62 percent). According to the type of device used to treat these patients, the distribution was 338 (57.0 percent), 169 (28.5 percent), 86 (14.5 percent), for ICDs, ICDs + CRT, CRT, respectively. After a mean follow-up time of 3.12 years (range 0 to 13.6 years), 283 devices were replaced (ICDs n = 140; ICDs + CRT n = 90; CRT n = 53) and 284 deaths occurred (median survival of 6.9 years). The median survival was 7.3, 5.8, 4.8, 5.5 years for ICDs single-chamber, ICDs dual-chamber, ICDs + CRT, CRT, respectively.ConclusionsRandomized trials are often criticized for their enrollment of highly selected patients. Studies on real-word data can provide reliable information regarding the use of ICDs and/or CRT devices in the treatment of patients with serious ventricular arrhythmias.