Temporal trends in population characteristics and type of device among primary prevention implantable cardioverter defibrillator recipients: The DAI-PP programme - 11/03/25
on
behalf of the DAI-PP investigators
Graphical abstract |
Highlights |
• | Over 20 years, the primary prevention ICD population has changed significantly. |
• | ICD recipients have become older, and the proportion of women has increased. |
• | ICD recipients also have narrower QRS complexes. |
• | The use of heart failure drug therapies has increased significantly. |
• | The proportion of CRT-Ds implanted has decreased. |
• | S-ICDs have assumed an central role in sudden cardiac death primary prevention. |
Abstract |
Background |
Patient characteristics, technology and clinical practice surrounding primary prevention implantable cardioverter defibrillators have evolved continuously over time.
Aim |
To explore the temporal changes in patient characteristics, pharmacological therapy and device types among implantable cardioverter defibrillator recipients implanted for the primary prevention of sudden cardiac death over the last two decades in France.
Methods |
Characteristics of participants and type of device from the retrospective DAI-PP Pilot Study (2002–2012) were compared with those from the ongoing prospective DAI-PP Consortium (2018 onwards).
Results |
This study included 9588 participants overall (DAI-PP Pilot Study, n=5539; DAI-PP Consortium, n=4049). Compared with the DAI-PP Pilot Study, the DAI-PP Consortium subjects were older at implantation (62.5 vs 65.2 years; P=0.001) and had a higher proportion of women (15.1% vs 20.6%; P<0.001), a similar proportion of ischaemic heart disease (60.2% vs 60.2%; P=0.98), a higher left ventricular ejection fraction (27±7% vs 30±8%; P<0.001) and more patients with narrow QRS complexes (30.5% vs 46.0%; P<0.001). The proportion of patients treated with heart failure drugs increased significantly (70.1% vs 83.1%; P<0.001), whereas the use of amiodarone became much less frequent (22.7% vs 14.7%; P<0.001). Finally, the proportions of cardiac resynchronization therapy defibrillators (53.8% vs 46.4%; P<0.001) and dual-chamber defibrillators (23.3% vs 17.3%; P<0.001) decreased, whereas subcutaneous implantable cardioverter defibrillators now account for a sizeable proportion of implants (14.6%).
Conclusions |
Over a 20-year period, the primary prevention implantable cardioverter defibrillator population has evolved significantly, with an older age and a higher proportion of women. The type of device has changed, with fewer cardiac resynchronization therapy defibrillators and more subcutaneous implantable cardioverter defibrillators.
Le texte complet de cet article est disponible en PDF.Keywords : Sudden cardiac death, Primary prevention, Implantable cardioverter defibrillator, Baseline characteristics, Temporal trends
Plan
Vol 118 - N° 3
P. 178-184 - mars 2025 Retour au numéro
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