Trends in the use of implantable cardioverter defibrillators in <scp>A</scp>ustralia: a 10‐year nationwide study from 2000–2009

Burch, A. W. T.; Wong, Christopher X.; Sullivan, Thomas; Brooks, A.; Leong, Darryl P.; Lau, Dennis H.; Sun, Michelle T.; Roberts‐Thomson, Kurt C.; Sanders, Prashanthan

doi:10.1111/imj.12201

Cited by 6 publications

(3 citation statements)

References 40 publications

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“…For example, we were not able to characterize trends in single‐ versus dual‐lead pacemakers, separate pacemakers by brand, determine the proportion of left ventricular lead implants which were upgrades, nor was data available on whether left ventricular lead insertions were for biventricular pacemakers or defibrillators. However, we have previously reviewed defibrillator trends, as opposed to the current report which focuses on pacing 21 …”

Section: Discussionmentioning

confidence: 99%

Trends in the use, complications, and costs of permanent pacemakers in Australia: A nationwide study from 2008 to 2017

Westaway

Nye

Gallagher

et al. 2021

Pacing Clinical Electrophis

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Objective To characterize contemporary pacemaker procedure trends. Methods Nationwide analysis of pacemaker procedures and costs between 2008 and 2017 in Australia. The main outcome measures were total, age‐ and gender‐specific implant, replacement, and complication rates, and costs. Results Pacemaker implants increased from 12,153 to 17,862. Implantation rates rose from 55.3 to 72.6 per 100,000, a 2.8% annual increase (incidence rate ratio [IRR] 1.028; 95% CI, 1.02–1.04; p < .001). Pacemaker implants in the 80+ age group were 17.37‐times higher than the < 50 group (95% CI 16.24–18.59; p < .001), and in males were 1.48‐times higher than in females (95% CI 1.42–1.55; p < .001). However, there were similar increases according to age (p = .10) and gender (p = .68) over the study period. Left ventricular lead rates were stable (IRR 0.995; 95% CI 0.98–1.01; p = .53). Generator replacements decreased from 20.5 to 18.3 per 100,000 (IRR 0.975; 95% CI 0.97–0.98; p < .001). Although procedures for generator‐related complications were stable (IRR 0.995; 95% CI 0.98–1.01; p = .54), those for lead‐related complications decreased (IRR 0.985; 95% CI 0.98–0.99; p < .001). Rates for all pacemaker procedures were consistently greater in males (p < .001). Although annual costs of all pacemaker procedures increased from $178 million to $329 million, inflation‐adjusted costs were more stable, rising from $294 million to $329 million. Conclusions Increasing demand for pacemaker implants is driven by the ageing population and rising rates across all ages, while replacement and complication procedure rates appeared more stable. Males have consistently greater pacemaker procedure rates than females. Our findings have significant clinical and public health implications for healthcare resource planning.

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Section: Discussionmentioning

confidence: 99%

Trends in the use, complications, and costs of permanent pacemakers in Australia: A nationwide study from 2008 to 2017

Westaway

Nye

Gallagher

et al. 2021

Pacing Clinical Electrophis

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“…In the United States, the ICD implantation rate increased from 6.1 % in 1993 to 46.2 % in 2006, with the average rate significantly increasing 17.9 % per year (95 % confidence interval [CI]: 17.6-18.3 %, p < 0.001) [ 5 ]. In Australia, the number of ICD implantations nationwide increased from 708 in 2000 to 3198 in 2009, with the implantation rate significantly increasing 19.2 % per year ( p < 0.001) [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of psycho-educational interventions on quality of life in patients with implantable cardioverter defibrillators: a meta-analysis of randomized controlled trials

Kao

Chen

et al. 2016

Health Qual Life Outcomes

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BackgroundImplantable cardioverter defibrillators (ICD) were developed for primary and secondary prevention of sudden cardiac death. However, ICD recipients’ mortality is significantly predicted by their quality of life (QOL). The aim of this meta-analysis was to evaluate the effects of psycho-educational interventions on QOL in patients with ICDs.MethodsWe systematically searched PubMed, Medline, Cochrane Library, and CINAHL through April 2015 and references of relevant articles. Studies were reviewed if they met following criteria: (1) randomized controlled trial, (2) participants were adults with an ICD, and (3) data were sufficient to evaluate the effect of psychological or educational interventions on QOL measured by the SF-36 or SF-12. Studies were independently selected and their data were extracted by two reviewers. Study quality was evaluated using a modified Jadad scale. The meta-analysis was conducted using the Cochrane Collaboration’s Review Manager Software Package (RevMan 5). Study heterogeneity was assessed by Q statistics and I2 statistic. Depending on heterogeneity, data were pooled across trials using fixed-effect or random-effect modeling.ResultsSeven randomized controlled trials fulfilled the inclusion and exclusion criteria, and included 1017 participants. The psycho-educational interventions improved physical component summary (PCS) scores in the intervention groups more than in control groups (mean difference 2.08, 95 % CI 0.86 to 3.29, p < 0.001), but did not significantly affect mental component summary (MCS) scores (mean difference 0.84, 95 % CI -1.68 to 3.35, p = 0.52).ConclusionOur meta-analysis demonstrates that psycho-educational interventions improved the physical component, but not the mental component of QOL in patients with ICDs.

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“…The use of ICDs has increased in many countries 11 . In Australia, two studies that quantified ICD procedure numbers by analysing routinely collected health data 12 , 13 found a marked increase in the numbers of insertion and replacement procedures over the past 20 years. No Australian studies have quantified the costs of ICD therapy or the rates of adverse procedures (including removal) and complications.…”

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confidence: 99%

Implantable cardioverter–defibrillator therapy in Australia, 2002–2015

Blanch

Lago

et al. 2018

Medical Journal of Australia

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The known Implantable cardioverteredefibrillators (ICDs) are life-saving devices that prevent sudden cardiac death.The new ICD procedure numbers are increasing in Australia. The highest rates are for people aged 70 or more; 90% of patients are over 35. ICD devices were removed from an average of one young, eight middle-aged and six older people each month during 2014e15. ICD-related hospitalisation procedures cost an estimated $154 555 814 in 2013e14.The implications Further investigations are needed to determine whether increasing rates of ICD therapy reflect evidence-based management decisions, to characterise the population receiving ICDs, and to quantify patterns of care and patient outcomes.I mplantable cardioverteredefibrillators (ICDs) are life-saving devices that prevent sudden cardiac death.1 The ICD is surgically inserted under the chest wall to monitor cardiac rhythm, and, in the event of life-threatening ventricular arrhythmias, delivers an electric shock. In accordance with the results of key clinical trials, 2,3 ICD therapy is recommended for patients at the greatest risk of sudden cardiac death; it is also recommended as secondary prevention for out-of-hospital cardiac arrest survivors, a patient group at clearly increased risk. Indications for ICD therapy as primary prevention are based on disease-specific guidelines that are imperfect; most sudden deaths are of patients deemed to be at low risk. 4 When making decisions about recommending ICD therapy, a clinician must weigh its life-saving benefits against the potential harms, including those associated with its surgical insertion, the need for ongoing 6-monthly device interrogations (functional checking), and battery replacement every 8e10 years. Patients with ICDs are at risk of inappropriate shocks, infection, lead fracture, thrombosis, and device or lead recall, which may result in ICD removal or adjustment procedures. The psychosocial burden includes greater risk of device-related anxiety 5 and post-traumatic stress after a shock.6 From a public health perspective, ICD therapy is associated with high costs after any appropriate or inappropriate shock, 7 although they are yet to be quantified in Australia.It has been reported that ICDs are both under-and overused in certain populations. For example, several studies have found only 13e40% of patients who meet guidelines for ICD therapy received it prior to a sudden cardiac event. 8,9 On the other hand, a recent American study found that as many as 23% of ICD insertions are inconsistent with clinical guidelines and identified an increased risk of adverse outcomes, including in-hospital death and postsurgical infection. 10The use of ICDs has increased in many countries. 11 In Australia, two studies that quantified ICD procedure numbers by analysing routinely collected health data 12,13 found a marked increase in the numbers of insertion and replacement procedures over the past 20 years. No Australian studies have quantified the costs of ICD therapy or the rates of adverse procedures (including r...

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Trends in the use of implantable cardioverter defibrillators in Australia: a 10‐year nationwide study from 2000–2009

Cited by 6 publications

References 40 publications

Trends in the use, complications, and costs of permanent pacemakers in Australia: A nationwide study from 2008 to 2017

Trends in the use, complications, and costs of permanent pacemakers in Australia: A nationwide study from 2008 to 2017

Effect of psycho-educational interventions on quality of life in patients with implantable cardioverter defibrillators: a meta-analysis of randomized controlled trials

Implantable cardioverter–defibrillator therapy in Australia, 2002–2015

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