Implantable Defibrillators Improve Survival Rates Following Sudden Cardiac Arrest

According to a new study, nearly 4 in 5 adults who receive implantable cardioverter-defibrillators (ICD) for secondary prevention following sudden cardiac arrest were still alive after 2 years. However, ICD is also associated with increased hospitalization and skilled nursing home admissions.

In their study, researchers collected data on 12,420 Medicare beneficiaries from the National Cardiovascular Data Registry ICD Registry who received their first ICD implantation for secondary prevention between 2006 and 2009. Participants included in the study were 65 years of age or older—25.3% were less than 70 years of age and 25.7% were 80 years of age or older at the time of implantation. The mean age was 75 years of age.
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Medicare claims were used to assess the risks of death, hospitalization, and admission into a skilled nursing facility over a 2-year period.

The risk of death at 2 years was 14.7% in participants who were less than 70 years of age and 28.9% in participants who were 80 years of age or older. Overall, the risk of death at 2 years was 21.8%.

Hospitalization incidences was 65.4% for all participants, 60.5% for participants who were less than 70 years of age, and 71.5% for participants who were 80 years of age or older.

Skilled nursing facility admissions were the highest in the first 30 days and ranged from 13.1% in participants who were less than 70 years of age to 31.9% in participants who were 80 years of age or older.

Overall, almost 4 in 5 patients survived for more than 2 years, but nearly two-thirds were hospitalized. In addition, 1 in 5 patients were admitted to skilled nursing facilities, and the risk for death, hospitalization, and skilled nursing facility admissions increased significantly with age. Participants who were 80 years of age or older were twice as likely to be admitted to a skilled nursing facility or die.

“These data provide a perspective on the magnitude of the expected outcomes of older patients receiving secondary prevention ICD therapy, and identify substantial care needs after device implantation in this population,” the researchers stated.

—Melissa Weiss

Reference:

Betz JK, Katz DF Peterson PN, et al. Outcomes among older patients receiving implantable cardioverter-defibrillators for secondary prevention [published online January 16, 2017]. Journal of American College of Cardiology. doi:10.1016/j.jacc.2016.10.062.