Patients With Advanced Heart Failure Face Higher Complication Rates From ICDs: Study

The findings of a new study suggest that some patients with heart failure may face a higher rate of complications if they receive implantable cardiac defibrillators (ICDs).

In a study published this week in the medical journal JAMA Cardiology, Duke University Researchers indicate that elderly patients suffering heart failure who had implantable cardiac defibrillators were more likely to experience in-hospital death and cardiac arrest after being resuscitated.

Researchers examined data on more than 81,000 Medicare beneficiary patients enrolled in the National Cardiovascular Data Registry (ICDC Registry) between January 2010 and December 2014. They studied patients with implantable cardioverter-defibrillators or cardiac resynchronization therapy-defibrillator placements.

The devices are implanted in the chest and monitor the heart’s rhythm. When the ICD detects an abnormal heartbeat, it is designed to deliver electric shocks through wire leads to put the heart back on a normal rhythm.

The study focused on elderly patients with an average age of 74, who had ICDs and advanced heart failure. The researchers compared them to control patients who had ICDs but did not have advanced heart failure.

According to the findings, patients who had advanced heart failure had higher rates of complications. The heart failure group had an in-hospital periprocedural complication rate of 3.74%. The control group’s complication rate was 1.10%. Periprocedural complications include those which occur directly before the medical procedure, during the medical procedure, and immediately after a medical procedure occurs.

Most adverse events were in-hospital deaths and resuscitated cardiac arrest.

The data indicated the death rate from any cause at 30 days was 3% among patients with advanced heart failure. Comparatively, the control group had a 30 day all cause death rate of 0.5%.

One year after receiving an ICD, patients with heart failure had an all cause death rate of 22%. This death rate was three times higher than patients without advanced heart failure.

Patients who had ischemic heart disease or diabetes had an even higher risk of death.

“Among patients undergoing these procedures, only a small proportion had advanced heart failure,” the researchers wrote. “These patients experienced clinically important periprocedural complication rates associated with in-hospital death and cardiac arrest relative to patients with non-advanced heart failure.”