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https://hdl.handle.net/2440/133925
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Type: | Journal article |
Title: | Cardiac implantable electronic devices: reoperations and the competing risk of death |
Author: | Gillam, M.H. Pratt, N.L. Inacio, M.C.S. Shakib, S. Caughey, G.E. Sanders, P. Lau, D.H. Roughead, E.E. |
Citation: | Heart Lung and Circulation, 2022; 31(4):537-543 |
Publisher: | Elsevier BV |
Issue Date: | 2022 |
ISSN: | 1443-9506 1444-2892 |
Statement of Responsibility: | Marianne H. Gillam, Nicole L. Pratt, Maria C.S. Inacio, Sepehr Shakib, Gillian E. Caughey, Prashanthan Sanders, Dennis H. Lau, Elizabeth E. Roughead |
Abstract: | Background: The use of cardiac implantable electronic devices (CIED), which includes pacemakers, implantable cardioverter-defibrillators (ICD), cardiac resynchronisation therapy pacemakers (CRT-P) and cardiac resynchronisation therapy defibrillators (CRT-D) has increased over the past 20 years, but there is a lack of real world evidence on the longevity of these devices in the older population which is essential to inform health care delivery and support clinical decisions. Methods and Results: We conducted a retrospective cohort study using data from the Australian Government Department of Veterans’ Affairs database. The cohort consisted of people who had a CIED procedure between 2005 and 2015. The cumulative risk of generator replacement/reoperations was estimated accounting for the competing risk of death. A total of 16,662 patients were included. In pacemaker recipients with an average age of 85 years, the 5-year risk of reoperation ranged from 2.8% in single chamber, 3.6% in dual chamber to 7.6% in CRT-P recipients, while the 5-year risk of dying with the index pacemaker in situ was 63% in single chamber, 46% in dual chamber and 56% in CRT-P recipients. In defibrillator recipients with an average age of 80 years, the 5-year risk of reoperation ranged from 11% in single chamber, 13% in dual chamber to 24% in CRT-D recipients, while the 5-year risk of dying with the index defibrillator in situ was 46% in single chamber, 40% in dual chamber and 41% in CRT-D recipients. Conclusion: In this cohort of older patients the 5-year risk of generator reoperation was low in pacemaker recipients whereas up to one in four CRT-D recipients would have a reoperation within 5 years. |
Keywords: | Cardiac implantable electronic devices; generator reoperation; competing risk; death |
Description: | Online published-ahead-of-print 19 October 2021 |
Rights: | © 2021 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved. |
DOI: | 10.1016/j.hlc.2021.08.027 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/GNT1040938 http://purl.org/au-research/grants/nhmrc/GNT1110139 |
Published version: | http://dx.doi.org/10.1016/j.hlc.2021.08.027 |
Appears in Collections: | Medicine publications |
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