Survival in Implant Recipients Outside Trials Favorable

Study reports one- and five-year survival of patients after cardiac device implantation

TUESDAY, Nov. 23 (HealthDay News) -- Patients who receive implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy-defibrillator (CRT-D) devices outside of clinical trials appear to fare as well as those who are followed in the device clinic setting, according to research published online Nov. 22 in Circulation.

Leslie A. Saxon, M.D., of the University of Southern California in Los Angeles, and colleagues assessed survival status in 185,778 ICD and CRT recipients to compare mortality rates in those followed up in device clinic settings with those who transmit remote data collected from the device an average of four times monthly.

The researchers found that the one- and five-year survival rates were 92 and 68 percent, respectively, for ICD recipients and 88 and 54 percent, respectively, for CRT-D recipients. Survival rates were higher in the 69,556 ICD and CRT-D recipients who received remote follow-up compared with the 116,222 patients who received follow-up in the device clinic setting. There was an association between shock therapy and risk of subsequent death for recipients of both ICD and CRT-D devices.

"Survival after ICD and CRT-D implantation in patients treated in naturalistic practice compares favorably with survival rates observed in clinical trials. Remote follow-up of device data is associated with excellent survival, but arrhythmias that result in device therapy in this population are associated with a higher mortality risk compared with patients who do not require shock therapy," the authors write.

Several authors disclosed financial relationships with medical device companies, including Boston Scientific, which funded the research.

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