Clinical and hospital factors affecting treatment with primary prevention implantable cardioverter-defibrillators in ischemic cardiomyopathy patients

Jae Hyuk Lee, Hee Tae Yu, Il Young Oh, Eue Keun Choi, Jung Hoon Sung, Young Soo Lee, Jong Youn Kim, Yongsoo Baek, Junbeom Park, Boyoung Joung

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Implantable cardioverter defibrillators (ICD) are the standard of care for primary prevention (PP) in patients with isch-emic cardiomyopathy (ICM). However, PP ICD implantation is underused in Asian countries. This study investigated ICD implantation rates and factors associated with appropriate PP ICD implants for ICM. Materials and Methods: In this prospective multicenter observational registry (ADVANCE-ICM registry), ICM patients who were eligible for PP ICD were screened and enrolled. Factors associated with appropriate ICD implantation, including hospital and clinical factors, were investigated. Results: Of the 1453 ICM patients eligible for PP ICD [1111 male; median age, 71.0 (61.0–78.0) years], only 76 (5.2%) patients un-derwent ICD implantation. Among hospital factors, a non-monetary incentive for referral (72.4% vs. 52.9%, p=0.001) and total hospital system score (6.0 vs. 5.0, p=0.013) were higher in the ICD than in the no-ICD group. In multivariate analysis, total hospital system score [odds ratio (OR), 1.28; 95% confidence interval (CI), 1.10–1.50] was an independent factor for predicting ICD im-plantation, along with clinical factors, including high New York Heart Association class (≥III: OR, 7.29; 95% CI, 2.97–17.87) and younger age (<70 years: OR, 2.14; 95% CI, 1.30–3.53). Conclusion: PP ICD implantation for ICM patients is underused in Korea. Hospital factors were important for improving PP ICD implantation rate, suggesting that new screening and referral systems for ICM patients would improve the PP ICD implantation rate (Clinical trial registration No. NCT03590925).

Original languageEnglish
Pages (from-to)942-950
Number of pages9
JournalYonsei medical journal
Volume61
Issue number11
DOIs
Publication statusPublished - 2020

Bibliographical note

Funding Information:
This study was supported by a research grant from Medtron-ics, Korea, and partially by the CMB-Yuhan research grant of Yonsei University College of Medicine (6-2019-0124).

Publisher Copyright:
© Yonsei University College of Medicine 2020.

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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