title: Implantable cardioverter-defibrillator longevity under clinical circumstances: an analysis according to device type, generation, and manufacturer.
abstract: BACKGROUND
  One of the major drawbacks of implantable cardioverter-defibrillator (ICD) treatment is the limited device service life. Thus far, data concerning ICD longevity under clinical circumstances are scarce. In this study, the ICD service life was assessed in a large cohort of ICD recipients.
  
  
  OBJECTIVE
  To assess the battery longevity of ICDs under clinical circumstances.
  
  
  METHODS
  All patients receiving an ICD in the Leiden University Medical Center were included in the analysis. During prospectively recorded follow-up visits, reasons for ICD replacement were assessed and categorized as battery depletion and non-battery depletion. Device longevity and battery longevity were calculated. The impact of device type, generation, manufacturer, the percentage of pacing, the pacing output, and the number of shocks on the battery longevity was assessed.
  
  
  RESULTS
  Since 1996, 4673 ICDs were implanted, of which 1479 ICDs (33%) were replaced. Mean device longevity was 5.0 ± 0.1 years. A total of 1072 (72%) ICDs were replaced because of battery depletion. Mean battery longevity of an ICD was 5.5 ± 0.1 years. When divided into different types, mean battery longevity was 5.5 ± 0.2 years for single-chamber ICDs, 5.8 ± 0.1 for dual-chamber ICDs, and 4.7 ± 0.1 years for cardiac resynchronization therapy-defibrillators (P <.001). Devices implanted after 2002 had a significantly better battery longevity as compared with devices implanted before 2002 (5.6 ± 0.1 years vs 4.9 ± 0.2 years; P <.001). In addition, large differences in battery longevity between manufacturers were noted (overall log-rank test, P <.001).
  
  
  CONCLUSIONS
  The majority of ICDs were replaced because of battery depletion. Large differences in longevity exist between different ICD types and manufacturers. Modern ICD generations demonstrated improved longevity.
authors.affiliation: Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Joep
authors.initials: J
authors.lastname: Thijssen
authors.forename: C Jan Willem
authors.initials: CJ
authors.lastname: Borleffs
authors.forename: Johannes B
authors.initials: JB
authors.lastname: van Rees
authors.forename: SumChe
authors.initials: S
authors.lastname: Man
authors.forename: Mihály K
authors.initials: MK
authors.lastname: de Bie
authors.forename: Jeroen
authors.initials: J
authors.lastname: Venlet
authors.forename: Enno T
authors.initials: ET
authors.lastname: van der Velde
authors.forename: Lieselot
authors.initials: L
authors.lastname: van Erven
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Schalij
mesh_terms: D002304:Cardiac Pacing, Artificial / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D017147:Defibrillators, Implantable / Q000706:statistics & numerical data*; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012044:Regression Analysis; D013997:Time Factors