Prevalence, Correlates, and Temporal Trends in Antiarrhythmic Drug Use at Discharge After Implantable Cardioverter Defibrillator Placement (from the National Cardiovascular Data Registry [NCDR])

• Published in: The American journal of cardiology 2014-01, Vol.113 (2), p.314-320
• Main Authors: Dev, Sandesh, MD, Peterson, Pamela N., MD, MPSH, Wang, Yongfei, MS, Curtis, Jeptha P., MD, Varosy, Paul D., MD, Masoudi, Frederick A., MD, MSPH
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Anti-Arrhythmia Agents - therapeutic use; Antiarrhythmics; Arrhythmias, Cardiac - physiopathology; Arrhythmias, Cardiac - therapy; Cardiac arrhythmia; Cardiovascular; Death, Sudden, Cardiac - epidemiology; Death, Sudden, Cardiac - prevention & control; Defibrillators, Implantable; Female; Follow-Up Studies; Heart attacks; Hospitalization; Hospitals; Humans; Male; Middle Aged; Patient Discharge; Prevalence; Registries; Retrospective Studies; Trends; United States - epidemiology
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2013.09.023

Patients with implantable cardioverter defibrillators (ICDs) can require antiarrhythmic drugs to manage arrhythmias and prevent device shocks. We sought to determine the prevalence, clinical correlates, and institutional variation in the use of antiarrhythmic drugs over time after ICD implantation. From the ICD Registry (2006 to 2011), we analyzed the trends in the use of antiarrhythmic agents prescribed at hospital discharge for patients undergoing first-time ICD placement. The patient, provider, and facility level variables associated with antiarrhythmic use were determined using multivariate logistic regression models. A median odds ratio was calculated to assess the hospital-level variation in the use of antiarrhythmic drugs. Of the cohort (n = 500,995), 15% had received an antiarrhythmic drug at discharge. The use of class III agents increased modestly (13.9% to 14.9%, p