title: Battery longevity from cardiac resynchronization therapy defibrillators: differences between manufacturers and discrepancies with published product performance reports.
abstract: OBJECTIVE
  Cardiac resynchronization therapy (CRT) is an important treatment for heart failure that requires constant ventricular pacing, placing a high energy burden on CRT defibrillators (CRT-D). Longer battery life reduces the need for device changes and associated complications, thereby affecting patient outcomes and cost of care. We therefore investigated the time to battery depletion of CRT-D from different manufacturers and compared these results with manufacturers' published product performance reports (PPRs).
  
  
  RESULTS
  All CRT-D recipients at our institution between January 2008 and December 2010 were included in this study cohort. The patients were followed up to the endpoint of battery depletion and were otherwise censored at the time of death, last follow-up, or device removal for any reason other than battery depletion. A total of 621 patients [173 Boston Scientific (BSC), 391 Medtronic (MDT), and 57 St. Jude Medical (SJM)] were followed up for a median of 3.7 (IQR 1.6-5.0) years, during which time 253 (41%) devices were replaced for battery depletion. Compared with MDT devices, battery depletion was 85 and 54% less likely to happen with BSC and SJM devices, respectively (P < 0.001 for pairwise comparisons). Product performance reports from all manufacturers significantly overestimated battery longevity by more than 20% 6 years after device implantation.
  
  
  CONCLUSIONS
  Large differences in CRT-D battery longevity exist between manufacturers. Industry-published PPRs significantly overestimate device longevity. These data have important implications to patients, healthcare professionals, hospitals, and third-party payers.
authors.forename: Mian Bilal
authors.initials: MB
authors.lastname: Alam
authors.forename: Muhammad Bilal
authors.initials: MB
authors.lastname: Munir
authors.forename: Rohit
authors.initials: R
authors.lastname: Rattan
authors.forename: Evan
authors.initials: E
authors.lastname: Adelstein
authors.forename: Sandeep
authors.initials: S
authors.lastname: Jain
authors.forename: Samir
authors.initials: S
authors.lastname: Saba
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D000369:Aged, 80 and over; D058406:Cardiac Resynchronization Therapy / Q000009:adverse effects; D058409:Cardiac Resynchronization Therapy Devices; D017147:Defibrillators, Implantable; D020878:Device Removal; D004554:Electric Countershock / Q000009:adverse effects / Q000295:instrumentation*; D011211:Electric Power Supplies; D004867:Equipment Design; D004868:Equipment Failure; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010414:Pennsylvania; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
keywords: Battery longevity; Cardiac resynchronization therapy; Implantable cardioverter-defibrillator; Manufacturer; Product performance report