title: Clinical profile and incidence of ventricular arrhythmia in patients undergoing defibrillator generator replacement in Spain.
abstract: OBJECTIVE
  Implantable cardioverter-defibrillators reduce mortality in some patients with heart disease. Battery replacement is a frequent occurrence in clinical practice and is required in up to 30% of implants. The benefit/risk ratio of defibrillators varies over time and should be reevaluated at the time of replacement. The aim of this study was to determine the clinical characteristics and incidence of defibrillator therapies in patients who underwent generator replacement.
  
  
  METHODS
  This multicenter retrospective study involved patients from the UMBRELLA national registry who underwent replacement due to defibrillator battery depletion. The incidence of ventricular arrhythmias was determined via remote monitoring. Risk factors for sustained ventricular arrhythmia after replacement were analyzed.
  
  
  RESULTS
  A total of 354 patients were included (mean age [standard deviation], 61.8 [14.5] years; men, 80%; secondary prevention, 42%; ventricular arrhythmias in the explanted generator, 62%). After a 25-month follow-up, 70 patients (20%) received appropriate therapies and 8 (2.3%) received inappropriate discharges. Male sex, structural heart disease, heart failure, and the absence of resynchronization were independent predictors of ventricular arrhythmia occurrence.
  
  
  CONCLUSIONS
  One-fifth of patients had appropriate defibrillator therapies in the first 2 years after generator replacement. Determination of the factors associated with arrhythmia occurrence after replacement may be useful to optimize implantable cardioverter-defibrillator treatment.
authors.affiliation: Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain. Electronic address: drfontenla@gmail.com.
authors.forename: Adolfo
authors.initials: A
authors.lastname: Fontenla
authors.affiliation: Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: María
authors.initials: M
authors.lastname: López Gil
authors.affiliation: Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Araba, Vitoria, Álava, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Martínez Ferrer
authors.affiliation: Unidad de Arritmias, Servicio de Cardiología, Hospital Virgen de la Victoria, Málaga, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Alzueta
authors.affiliation: Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario Puerta de Hierro, Majadahonda, Madrid, Spain.
authors.forename: Ignacio
authors.initials: I
authors.lastname: Fernández Lozano
authors.affiliation: Unidad de Arritmias, Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Xavier
authors.initials: X
authors.lastname: Viñolas
authors.affiliation: Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario de Canarias, Sta. Cruz de Tenerife, Spain.
authors.forename: Aníbal
authors.initials: A
authors.lastname: Rodríguez
authors.affiliation: Unidad de Arritmias, Servicio de Cardiología, Hospital Infanta Cristina, Badajoz, Spain.
authors.forename: Joaquín
authors.initials: J
authors.lastname: Fernández de la Concha
authors.affiliation: Unidad de Arritmias, Servicio de Cardiología, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Ignasi
authors.initials: I
authors.lastname: Anguera
authors.affiliation: Unidad de Arritmias, Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Arribas
mesh_terms: D001145:Arrhythmias, Cardiac / Q000453:epidemiology* / Q000628:therapy; D017147:Defibrillators, Implantable / Q000009:adverse effects; D004868:Equipment Failure; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D013030:Spain / Q000453:epidemiology
keywords: Appropriate therapies; Arritmias ventriculares; Desfibrilador automático implantable; Generator replacement; Implantable cardioverter-defibrillator; Recambio de generador; Terapias apropiadas; Ventricular arrhythmias