Impact of the main implantable cardioverter-defibrillator trials in clinical practice: data from the Italian ICD Registry for the years 2005-07

Europace. 2009 Apr;11(4):465-75. doi: 10.1093/europace/eun370. Epub 2009 Jan 9.

Abstract

Aims: Several studies have demonstrated the life-saving role of implantable cardioverter-defibrillator (ICD) therapy. In order to evaluate the effects of major trials in clinical practice, we report the clinical data of patients enrolled in the Italian ICD Registry for the years 2005-07.

Methods and results: The Registry collects prospectively national ICD implantation activity on the basis of EURID Card. The number of ICDs per million of inhabitants was 180.6 in the year 2005, 192.5 in the year 2006, and 220.6 in the year 2007 (P = 0.02). The median age was 69 years for all 3 years considered. Implantable cardioverter-defibrillator implantation for primary prevention concerned 4692 patients in 2005 (44.2%), 5938 patients in 2006 (52.2%), 7324 patients in 2007 (55.7%) and for secondary prevention 5921 patients in 2005 (55.8%), 5447 patients in 2006 (47.8%), and 5828 patients in 2007 (44.3%). Single-chamber ICDs were implanted in 30.9, 31.0, and 28.5% of patients, dual chamber ICDs in 31.9, 31.5, and 31.7%, and biventricular ICDs in 37.2, 37.5, and 39.8%, respectively.

Conclusion: The ICD implantation rate in Italy increased significantly in the period 2005-07. The registry showed a significant increase in prophylactic and biventricular ICD use, reflecting a favourable adherence to trials and guidelines in the clinical practice.

MeSH terms

  • Aged
  • Anti-Arrhythmia Agents / therapeutic use
  • Arrhythmias, Cardiac / physiopathology
  • Arrhythmias, Cardiac / therapy*
  • Cohort Studies
  • Death, Sudden, Cardiac / prevention & control
  • Defibrillators, Implantable / statistics & numerical data*
  • Defibrillators, Implantable / trends*
  • Electrocardiography
  • Female
  • Guideline Adherence
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Prospective Studies
  • Registries / statistics & numerical data*
  • Retrospective Studies
  • Stroke Volume / physiology
  • Ventricular Dysfunction, Left / physiopathology

Substances

  • Anti-Arrhythmia Agents