Implantable cardioverter-defibrillator (ICD) implantation is associated with a high risk of long-term complications and reoperation, especially for younger patients, females, and blacks. The observational cohort study is published in Annals of Internal Medicine.
ICDs are highly efficacious in preventing sudden cardiac death and reducing mortality in select populations, yet early complications are common. Less is known about the long-term risks of ICDs and how patient and device characteristics at implantation affect outcomes.
Using data from the National Cardiovascular Data Registry ICD registry and Medicare claims, researchers assessed the long-term nonfatal risks for ICD-related complications among patients with first-time implantations. Based on data from more than 114,000 patients at 1,437 centers, ICDs were associated with a high risk for complications and reoperations in the years after implantation. Increasing complexity of the implanted device (particularly CRT-D devices), younger age at implantation, female sex, and black race were associated with the greatest long-term hazards for complications. The researchers suggest that these findings be considered during the decision-making process before implantation.