Predicted longevity of contemporary cardiac implantable electronic devices: A call for industry-wide “standardized” reporting

Dian A. Munawar, Rajiv Mahajan, Dominik Linz, Geoffrey R. Wong, Kashif B. Khokhar, Anand Thiyagarajah, Kadhim Kadhim, Mehrdad Emami, Ricardo Mishima, Adrian D. Elliott, Melissa E. Middeldorp, Kurt C. Roberts-Thompson, Glenn D. Young, Prash Sanders, Dennis H. Lau

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Battery longevity is an important factor that may influence the selection of cardiac implantable electronic devices (CIEDs). However, there remains a lack of industry-wide standardized reporting of predicted CIED longevity to facilitate informed decision-making for implanting physicians and payers. Objective: The purpose of this study was to compare the predicted longevity of current generation CIEDs using best-matched CIEDs settings to assess differences between brands and models. Methods: Data were extracted for current model pacemakers, implantable cardioverter–defibrillators (ICDs), and cardiac resynchronization therapy–defibrillators (CRT-Ds) from product manuals and, where absent, by communication with the manufacturers. Pacemaker longevity estimations were based on standardized pacing outputs (2.5V, 0.40-ms pulse width, 500-Ω impedance) and pacing loads of 50% or 100% at 60 bpm. ICD and CRT-D longevity were estimated at 0% pacing and 15% atrial plus 100% biventricular pacing, with essential capacitor reforms and zero clinical shocks. Results: Mean maximum predicted longevity of single- and dual-chamber pacemakers was 12.0 ± 2.1 and 9.8 ± 1.9 years, respectively. Use of advanced features such as remote monitoring, prearrhythmia electrogram storage, and rate response can result in ∼1.4 years of reduction in longevity. Mean maximum predicted longevity of ICDs and CRT-Ds was 12.4 ± 3.0 and 8.8 ± 2.1 years, respectively. Of note, there were significant variations in predicted CIED longevity according to device manufacturers, with up to 44%, 42%, and 44% difference for pacemakers, ICDs, and CRT-Ds, respectively. Conclusion: Contemporary CIEDs demonstrate highly variable predicted longevity according to device manufacturers. This may impact on health care costs and long-term clinical outcomes.

Original languageEnglish
Pages (from-to)1756-1763
Number of pages8
JournalHeart Rhythm
Volume15
Issue number12
DOIs
Publication statusPublished - 1 Dec 2018

Keywords

  • Battery longevity
  • Cardiac implantable electronic device
  • Cardiac resynchronization therapy
  • Implantable cardioverter-defibrillator
  • Pacemaker

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Munawar, D. A., Mahajan, R., Linz, D., Wong, G. R., Khokhar, K. B., Thiyagarajah, A., ... Lau, D. H. (2018). Predicted longevity of contemporary cardiac implantable electronic devices: A call for industry-wide “standardized” reporting. Heart Rhythm, 15(12), 1756-1763. https://doi.org/10.1016/j.hrthm.2018.07.029