Seven years of use of implantable cardioverter-defibrillator therapies: a nationwide population-based assessment of their effectiveness in real clinical settings

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dc.contributor.authorMigowski, Arn
dc.contributor.authorRibeiro, Antonio Luiz
dc.contributor.authorCarvalho, Marilia Sá
dc.contributor.authorAzevedo, Vitor Manuel Pereira
dc.contributor.authorChaves, Rogério Brant Martins
dc.contributor.authorHashimoto, Lucas de Aquino
dc.contributor.authorXavier, Carolina de Aquino
dc.contributor.authorXavier, Regina Maria de Aquino
dc.date.accessioned2022-08-08T14:23:54Z
dc.date.available2022-08-08T14:23:54Z
dc.date.issued2015
dc.description.abstractBackground: The efficacy of implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy-defibrillator (CRT-D) therapy has already been established in clinical trials but their effectiveness in several clinical settings remains undetermined. This study aimed to assess the effectiveness of ICD and CRT-D therapies within the Brazilian National Health System (SUS). Methods: All patients who underwent ICD or CRT-D implantation within the SUS from 2001 to 2007 were included in the study. We compared estimated Kaplan-Meier survival curves using the Peto’s test. Prognostic factors were selected using Cox’s models. Results: There were included 3,295 patients in the ICD group and 681 patients in the CRT-D group. Cardiac causes accounted for 79% of all deaths in both groups and Chagas’ heart disease accounted for 31% of these deaths. In the CRT-D group, survival significantly decreased around the fourth year of follow-up, with a decrease from 59.5% to 38.3% in 5.5 months. Transvenous implantation technique was used in 62% of CRT-D patients. In-hospital case-fatality rates were higher in those undergoing surgical implantation (5.3%) than those undergoing transvenous implantation (1.6%) (p = 0.02). Conclusions: The results show that short-term, medium-term and long-term effectiveness of ICD therapy appears to be similar to that evidenced in clinical trials. In the CRT-D group, in-hospital case-fatality and 30-day case-fatality were higher than those reported in other studies. Surgical epicardial implantation technique was performed in this group at a higher frequency than that reported in the literature and was associated with poorer short-term prognosis.
dc.identifier.citationMigowski A, Ribeiro AL, Carvalho MS, Azevedo VMP, Chaves RBM, Hashimoto LA et al. Seven years of use of implantable cardioverter-defibrillator therapies: a nationwide population-based assessment of their effectiveness in real clinical settings. BMC Cardiovasc Disorder 2015 Mar;13;15(22). doi: 10.1186/s12872-015-0016-2. PMID: 25888219; PMCID: PMC4364497.
dc.identifier.urihttps://dspace.inc.saude.gov.br/handle/123456789/59
dc.language.isoen
dc.publisherBMC Cardiovascular Disorders
dc.subjectImplantable defibrillatorsen
dc.subjectCardiac resynchronization therapy devicesen
dc.subjectChagas cardiomyopathyen
dc.subjectSurvival analysisen
dc.subjectMedical record linkageen
dc.subjectTechnology assessmenten
dc.subjectHospital mortalityen
dc.subjectHigh-cost technologyen
dc.subject.meshYoung Adulten
dc.subject.meshProportional Hazards Modelsen
dc.subject.meshMiddle Ageden
dc.subject.meshMaleen
dc.subject.meshKaplan-Meier Estimateen
dc.subject.meshHumansen
dc.subject.meshHospital Mortalityen
dc.subject.meshFollow-Up Studiesen
dc.subject.meshDefibrillators, Implantableen
dc.subject.meshChilden
dc.subject.meshChagas Cardiomyopathy / therapyen
dc.subject.meshChagas Cardiomyopathy / mortalityen
dc.subject.meshCause of Deathen
dc.subject.meshCardiovascular Diseases / therapyen
dc.subject.meshCardiovascular Diseases / mortalityen
dc.subject.meshCardiomyopathies / therapyen
dc.subject.meshCardiomyopathies / mortalityen
dc.subject.meshCardiac Resynchronization Therapy / methodsen
dc.subject.meshBrazil / epidemiologyen
dc.subject.meshAgeden
dc.subject.meshAdulten
dc.subject.meshAdolescenten
dc.titleSeven years of use of implantable cardioverter-defibrillator therapies: a nationwide population-based assessment of their effectiveness in real clinical settings
dc.typeArticle
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