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Vol 11, No 6 (2016)
Original Papers
Published online: 2017-01-14
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Changing trends in the use of cardiac implantable electronic devices over 14 years of practice at a cardiology reference center

Elżbieta Barbara Świętoń, Roman Steckiewicz, Marcin Grabowski, Przemysław Stolarz
DOI: 10.5603/FC.2016.0106
·
Folia Cardiologica 2016;11(6):497-503.

open access

Vol 11, No 6 (2016)
Original Papers
Published online: 2017-01-14

Abstract

Introduction. Indications for the use of cardiac implantable electronic devices (CIEDs) have been expanded over the years, just as there has been progress in CIED technology. Open cardiothoracic surgeries have been replaced by transvenous procedures conducted with only local anesthesia. These factors have effected certain changes in the quantity, proportions, and types of implanted devices. However, it takes a long observation period to determine the direction, duration, or rapidity of such trend changes as well as to project the relevant figures for the future.
Material and methods. This retrospective analysis included CIED implantation procedures performed at our center in the period from 2002 to 2015. The analyses were based on medical records, including: procedure logs, procedure reports, and outpatient follow-up entries. This manuscript includes a year-by-year analysis of selected types of CIED-related procedures, i.e.: de novo device implantation, device replacement, and device upgrade procedures.
Results. A total of 7,921 CIED-related procedures were conducted in the evaluated period. Female patients constituted 52% and males 48% (mean age 72.7 years). De novo device implantation procedures constituted 68.5% of all CIED-related procedures, device replacement due to predicted battery depletion was conducted in 24.4% of cases, and the remaining 7.1% of procedures were classified as ‘other’. The de novo device implantation group involved pacemaker (PM) implantation procedures (81.7%) including single-chamber atrial (AAI) (6.2%) and ventricular (VVI) (49.6%) devices and dual-chamber atrioventricular (DDD) (43.8%) devices. The remaining 18.3% of the de novo procedures were implantable cardioverter-defibrillators (ICD) (83.2%) including dual (ICD-DR) (26.0%) and single-chamber (ICD-VR) (57.2%) devices and cardiac resynchronization therapy defibrillators (CRT-D) (16.7%). Single-chamber to dual-chamber pacemaker replacement procedures constituted 82.4% of all CIED upgrade procedures. The remaining 17.6% of device upgrade procedures included adding new functions, such as terminating ventricular tachyarrhythmias (upgrade to ICD) and/or cardiac resynchronization (upgrade to CRT-D).
Conclusions. The general rise in the number of CIED-related procedures saw increasing proportions of ICD and CRT device use both in the de novo device implantation and device upgrade groups. Our projections indicate a persistent trend of increasing number of CIED-related procedures discussed in this manuscript.

Abstract

Introduction. Indications for the use of cardiac implantable electronic devices (CIEDs) have been expanded over the years, just as there has been progress in CIED technology. Open cardiothoracic surgeries have been replaced by transvenous procedures conducted with only local anesthesia. These factors have effected certain changes in the quantity, proportions, and types of implanted devices. However, it takes a long observation period to determine the direction, duration, or rapidity of such trend changes as well as to project the relevant figures for the future.
Material and methods. This retrospective analysis included CIED implantation procedures performed at our center in the period from 2002 to 2015. The analyses were based on medical records, including: procedure logs, procedure reports, and outpatient follow-up entries. This manuscript includes a year-by-year analysis of selected types of CIED-related procedures, i.e.: de novo device implantation, device replacement, and device upgrade procedures.
Results. A total of 7,921 CIED-related procedures were conducted in the evaluated period. Female patients constituted 52% and males 48% (mean age 72.7 years). De novo device implantation procedures constituted 68.5% of all CIED-related procedures, device replacement due to predicted battery depletion was conducted in 24.4% of cases, and the remaining 7.1% of procedures were classified as ‘other’. The de novo device implantation group involved pacemaker (PM) implantation procedures (81.7%) including single-chamber atrial (AAI) (6.2%) and ventricular (VVI) (49.6%) devices and dual-chamber atrioventricular (DDD) (43.8%) devices. The remaining 18.3% of the de novo procedures were implantable cardioverter-defibrillators (ICD) (83.2%) including dual (ICD-DR) (26.0%) and single-chamber (ICD-VR) (57.2%) devices and cardiac resynchronization therapy defibrillators (CRT-D) (16.7%). Single-chamber to dual-chamber pacemaker replacement procedures constituted 82.4% of all CIED upgrade procedures. The remaining 17.6% of device upgrade procedures included adding new functions, such as terminating ventricular tachyarrhythmias (upgrade to ICD) and/or cardiac resynchronization (upgrade to CRT-D).
Conclusions. The general rise in the number of CIED-related procedures saw increasing proportions of ICD and CRT device use both in the de novo device implantation and device upgrade groups. Our projections indicate a persistent trend of increasing number of CIED-related procedures discussed in this manuscript.

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Keywords

implantable cardioverter-defibrillators, cardiac pacemakers, retrospective study

About this article
Title

Changing trends in the use of cardiac implantable electronic devices over 14 years of practice at a cardiology reference center

Journal

Folia Cardiologica

Issue

Vol 11, No 6 (2016)

Pages

497-503

Published online

2017-01-14

DOI

10.5603/FC.2016.0106

Bibliographic record

Folia Cardiologica 2016;11(6):497-503.

Keywords

implantable cardioverter-defibrillators
cardiac pacemakers
retrospective study

Authors

Elżbieta Barbara Świętoń
Roman Steckiewicz
Marcin Grabowski
Przemysław Stolarz

References (12)
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