Comorbidities Important in Decision-making for ICD Generator Replacement

Comorbid illnesses should be considered in the decision to replace an implantable cardioverter defibrillator (ICD), according to a new study published in Circulation: Arrhythmia and Electrophysiology. A research team seeking outcomes data for implantable cardioverter defibrillator generator replacement looked at patients with ischemic or nonischemic cardiomyopathy undergoing ICD generator replacement in a 10-year period in two major American medical centers. Outcomes of interest included appropriate therapy after generator replacement and death prior to appropriate therapy following generator replacement. According to the results, 435 of 1,421 patients undergoing ICD generator replacement received appropriate therapy after replacement. Death prior to appropriate therapy occurred in 336 patients and was associated with a range of comorbidities (old age, lower LVEF, diabetes, chronic lung disease, peripheral vascular disease, low hemoglobin, and lower glomerular filtration rate).

Witt C, Waks J, Mehta R, et al. Circ Arryth Electrophysiol. 2018;doi:10.1161/CIRCEP.117.006155