ICD Implantation: How Good Are We?

Some interesting data were published in the journal HeartRhythm recently:

Based on the registry, which has collected data on 486,025 ICD implants from 2006 to 2009, the demographics of ICD recipients are mainly male (73.8 percent), approximately 68 years of age, Caucasian (82.8 percent), high rates of hypertension (75.3 percent) and relatively low rates of diabetes (36.7 percent).

Some key findings from the 2009 registry include:

• Total complications for new implants (including death in the laboratory) have decreased over time from 3.77 percent in 2006 to 2.87 percent in 2009.


• Medicare beneficiaries accounted for 67.7 percent of patients.


• The device was placed for primary prevention in 78 percent of patients, two-thirds with coronary artery disease, the average left ventricular ejection fraction was 29 percent, and 82 percent were NYHA Class II-III.


• Among 5,246 physicians who implanted ICDs between 2006 and 2009, only 438 physicians provided information about their training. Among those 438 physicians, 56 percent completed an electrophysiology fellowship, accounting for 83 percent of ICD implants.


• Of patients receiving cardiac resynchronization therapy with defibrillation, 68 percent were shown to meet published national guidelines.


• Of patients receiving an ICD for primary prevention of sudden death, 78 percent met published national guidelines.

-Wes