Pacemaker Use in New Zealand – Data From the New Zealand Implanted Cardiac Device Registry (ANZACS-QI 15)

Larsen, Peter; Kerr, Andrew; Hood, Margaret; Harding, Scott; Hooks, Darren; Heaven, David; Lever, Nigel; Sinclair, Susan; Boddington, Dean; Tang, Elaine; Swampillai, J.; Stiles, Martin K.

doi:10.1016/j.hlc.2016.06.1206

Cited by 14 publications

(18 citation statements)

References 11 publications

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“…The first description of data on new pacemaker implants from this Registry has been recently published. 38 We believe our study adds to the ANZACS-QI 15 data, giving a more detailed picture of current New Zealand practice with primary prevention ICD/CRT-D use in selected HF patients. Based on our observational study, effective ICD/CRT-D in appropriately selected HF patients resulted in a very low incidence of arrhythmic death.…”

Section: Limitationsmentioning

confidence: 82%

“…The New Zealand Cardiac Implanted Device Registry (ANZACS‐QI 15) has recently been developed to collect information on all cardiac device implantations in New Zealand, which will aid quality improvement initiatives and to allow subsequent examination of equity of access to therapy, outcomes, and complications in a “real‐world” view. The first description of data on new pacemaker implants from this Registry has been recently published . We believe our study adds to the ANZACS‐QI 15 data, giving a more detailed picture of current New Zealand practice with primary prevention ICD/CRT‐D use in selected HF patients.…”

Section: Limitationsmentioning

confidence: 82%

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Long‐term outcomes of heart failure patients who received primary prevention implantable cardioverter‐defibrillator: An observational study

Looi

Sidhu

Cooper

et al. 2017

Journal of Arrhythmia

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BackgroundImplantable cardioverter‐defibrillator (ICD) therapy is indicated for selected heart failure patients for the primary prevention of sudden cardiac death. Little is known about the outcomes in patients selected for primary prevention device therapy in the northern region of New Zealand.MethodHeart failure patients with systolic dysfunction who underwent primary prevention ICD/cardiac resynchronization therapy‐defibrillator (CRT‐D) implantation between January 1, 2007, and June 1, 2015, were included. Complications, mortality, and hospitalization events were reviewed.ResultsThree hundred and eighty‐five primary prevention devices were implanted (269 ICD, 116 CRT‐D). Mean age at implant was 59.1 ± 11.4 years. Mean duration of follow‐up was 3.64 ± 2.17 years. The commonest cause of death was heart failure (41.8%). Only 2 patients died from sudden arrhythmic death. The 5‐year heart failure mortality rate was 6%, whereas the 5‐year sudden arrhythmic death rate was 0.3%. Heart failure hospitalizations were commoner in those who received ICD than CRT‐D (67.7% vs 25.8%, P < .001). Maori patients have low implant rates (14%) with relatively high rates of admissions with heart failure and ventricular arrhythmia admissions,ConclusionsEven in appropriately selected heart failure patients who received primary prevention devices, only a small percentage died as a result of sudden arrhythmic death. CRT‐D should be the device of choice where appropriate in heart failure patients. Significant challenges remain to improve access to device therapy and maximize benefit to those who do get implanted.

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Section: Limitationsmentioning

confidence: 82%

Section: Limitationsmentioning

confidence: 82%

Long‐term outcomes of heart failure patients who received primary prevention implantable cardioverter‐defibrillator: An observational study

Looi

Sidhu

Cooper

et al. 2017

Journal of Arrhythmia

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“…It was built upon the ANZACS‐QI platform and introduced to NZ public hospitals in 2014 through a grant from the NZ branch of the Cardiac Society of Australia and New Zealand (CSANZ) . The ANZACS‐QI DEVICE Registry has been used previously to describe the clinical characteristics and implant details of patients receiving new pacemaker implants . Our study aims to describe the contemporary NZ use of ICD and CRT, utilizing the ANZACS‐QI DEVICE Registry.…”

Section: Introductionmentioning

confidence: 99%

Implantable cardioverter defibrillator and cardiac resynchronization therapy use in New Zealand (ANZACS‐QI 33)

Foo

Lee

Looi

et al. 2019

Journal of Arrhythmia

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on behalf of the ANZACS-QI investigatorsThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. AbstractBackground: The ANZACS-QI Cardiac Implanted Device Registry (ANZACS-QI DEVICE) collects nationwide data on cardiac implantable electronic devices in New Zealand (NZ). We used the registry to describe contemporary NZ use of implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy (CRT). Methods: All ICD and CRT Pacemaker implants recorded in ANZACS-QI DEVICEbetween 1 January 2014 and 31 December 2017 were analyzed. Results:Of 1579 ICD implants, 1152 (73.0%) were new implants, including 49.0% for primary prevention and 51.0% for secondary prevention. In both groups, median age was 62 years and patients were predominantly male (81.4% and 79.2%, respectively).Most patients receiving a primary prevention ICD had a history of clinical heart failure (80.4%), NYHA class II-III symptoms (77.1%) and LVEF ≤35% (96.9%). In the secondary prevention ICD cohort, 88.4% were for sustained ventricular tachycardia or survived cardiac arrest from ventricular arrhythmia. Compared to primary prevention CRT Defibrillators (n = 155), those receiving CRT Pacemakers (n = 175) were older (median age 74 vs 66 years) and more likely to be female (38.3% vs 19.4%). Of the 427 (27.0%) ICD replacements (mean duration 6.3 years), 46.6% had received appropriate device therapy while 17.8% received inappropriate therapy. The ICD implant rate was 119 per million population with regional variation in implant rates, ratio of primary prevention ICD implants, and selection of CRT modality. Conclusion:In contemporary NZ practice three-quarters of ICD implants were new implants, of which half were for primary prevention. The majority met current guideline indications. Patients receiving CRT pacemaker were older and more likely to be female.

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“…The New Zealand Cardiac Implanted Device Registry has recently been developed on the All New Zealand Acute Coronary Syndrome-Quality Improvement platform 5. The first description of data on new pacemaker implants from this Registry has been recently published 5.…”

Section: Introductionmentioning

confidence: 99%

“…The first description of data on new pacemaker implants from this Registry has been recently published 5. Data on ICD implants are still pending.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of patients with heart failure after primary prevention ICD unit generator replacement

et al. 2019

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ObjectiveData describing outcomes after implantable cardioverter-defibrillator (ICD) unit generator replacement in patients with heart failure (HF) with primary prevention devices are limited.MethodData on patients with HF who underwent primary prevention ICD/cardiac resynchronisation therapy-defibrillator (CRT-D) implantation from 2007 until mid-2015 who subsequently received unit generator replacement were analysed. Outcomes assessed were mortality, appropriate ICD therapy and shock, and procedural complications.Results61 of 385 patients with HF with primary prevention ICD/CRT-D undergoing unit generator replacement were identified. Follow-up period was 1.8±1.5 years after replacement. 43 (70.5%) patients had not received prior appropriate ICD therapy prior to unit replacement. The cumulative risks of appropriate ICD therapy at 1, 3 and 5 years after unit replacement in those without prior ICD therapy were 0%, 6.2% and 50% compared with 6.2%, 59.8% and 86.6%, respectively (p=0.005) in those with prior ICD therapies. No predictive factors associated with appropriate ICD therapy after replacement could be identified. 41 (32.8%) patients no longer met guideline indications at the time of unit replacement but risks of subsequent appropriate ICD interventions were not different compared with those who continued to meet primary prevention ICD indications.The 5-year mortality risk after unit replacement was 18.4% and there were high procedural complication rates (9.8%).ConclusionNo predictive marker successfully stratified patients no longer needing ICD support prospectively. Finding such a marker is important in decision-making about device replacement particularly given the concerns about the complication rates. These factors should be considered at the time of ICD unit replacement.

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Pacemaker Use in New Zealand – Data From the New Zealand Implanted Cardiac Device Registry (ANZACS-QI 15)

Cited by 14 publications

References 11 publications

Long‐term outcomes of heart failure patients who received primary prevention implantable cardioverter‐defibrillator: An observational study

Long‐term outcomes of heart failure patients who received primary prevention implantable cardioverter‐defibrillator: An observational study

Implantable cardioverter defibrillator and cardiac resynchronization therapy use in New Zealand (ANZACS‐QI 33)

Outcomes of patients with heart failure after primary prevention ICD unit generator replacement

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