Key result
In contemporary New Zealand practice, 73.0% of ICD implants were new implants, of which 49.0% were for primary prevention, with an overall ICD implant rate of 119 per million population in 2016.
Why the study?
The registry was used to describe contemporary use of implantable cardioverter defibrillators and cardiac resynchronization therapy across New Zealand.
Observational (n=1,579)
Yes
In contemporary New Zealand practice, the majority of ICD implants meet current guideline indications, though there is regional variation in implant rates and CRT modality selection.
BACKGROUND: The ANZACS-QI Cardiac Implanted Device Registry (ANZACS-QI DEVICE) collects nationwide data on cardiac implantable electronic devices in New Zealand (NZ). We used the registry to describe contemporary NZ use of implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy (CRT). METHODS: All ICD and CRT Pacemaker implants recorded in ANZACS-QI DEVICE between 1 January 2014 and 31 December 2017 were analyzed. RESULTS: Of 1579 ICD implants, 1152 (73.0%) were new implants, including 49.0% for primary prevention and 51.0% for secondary prevention. In both groups, median age was 62 years and patients were predominantly male (81.4% and 79.2%, respectively). Most patients receiving a primary prevention ICD had a history of clinical heart failure (80.4%), NYHA class II-III symptoms (77.1%) and LVEF ≤35% (96.9%). In the secondary prevention ICD cohort, 88.4% were for sustained ventricular tachycardia or survived cardiac arrest from ventricular arrhythmia. Compared to primary prevention CRT Defibrillators (n = 155), those receiving CRT Pacemakers (n = 175) were older (median age 74 vs 66 years) and more likely to be female (38.3% vs 19.4%). Of the 427 (27.0%) ICD replacements (mean duration 6.3 years), 46.6% had received appropriate device therapy while 17.8% received inappropriate therapy. The ICD implant rate was 119 per million population with regional variation in implant rates, ratio of primary prevention ICD implants, and selection of CRT modality. CONCLUSION: In contemporary NZ practice three-quarters of ICD implants were new implants, of which half were for primary prevention. The majority met current guideline indications. Patients receiving CRT pacemaker were older and more likely to be female.
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Foo et al. (2019) conducted an observational in Heart failure and ventricular arrhythmias (n=1,579). Implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy (CRT) was evaluated on Device implant characteristics and rates. In contemporary New Zealand practice, 73.0% of ICD implants were new implants, of which 49.0% were for primary prevention, with an overall ICD implant rate of 119 per million population in 2016.
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