New Data Highlights Differences In CRT-ICD Battery Longevity

An independent and first-of-its-kind study published online this week in EP EuroPace shows there are significant differences in battery longevity between contemporary cardiac resynchronization therapy defibrillator (CRT-D) devices, and that Boston Scientific Corporation’s device has the longest battery life compared to competitive brands. 

The University of Pittsburgh Medical Center study noted that battery life can have direct implications on patient outcomes and may therefore impact clinical practice in CRT-D therapy. EP EuroPace is the official journal of the European Society of Cardiology European Heart Rhythm Association.

The retrospective, observational study focused on 646 patients who were implanted with current models of CRT-D defibrillators between Jan. 1, 2008, and Dec. 31, 2010. The primary endpoints were the rate of battery depletion (reaching elective replacement indicator or ERI), as well as the time from device implantation to battery depletion as specified by device manufacturer. Overall, study data demonstrated the shortest battery longevity in contemporary Medtronic Inc. CRT-D models compared with comparable devices from other manufacturers.

During 2.7+/-1.5 years follow-up, only 4 percent of Boston Scientific device batteries had depleted, compared to 7 percent from St. Jude Medical Inc. and 25 percent from Medtronic (p<0.001). Moreover, the four-year battery survival rate of the Boston Scientific device was 94 percent, compared with 92 percent from St. Jude and 67 percent from Medtronic (p<0.001).

“This study offers critically important information for patients and physicians alike,” said Kenneth Stein, M.D., chief medical officer for Boston Scientific’s Cardiac Rhythm Management division. “With improved therapies, the majority of today’s heart failure patients will outlive their implantable device.^[i],[ii] A recent study showed that nine percent of patients who have a device replacement experienced a complication or device infection.^[iii] As patients live longer, the benefit from longer-lasting devices and fewer replacement surgeries becomes increasingly significant.”

Cardiac resynchronization therapy (CRT) implantable cardioverter defibrillators (ICDs) are designed to manage heart failure in patients with severe left ventricular (LV) systolic dysfunction and a wide QRS complex. ^{[iv],[v],[vi]} The benefit of CRT-ICDs depends upon achieving a high burden of ventricular pacing in both the right and left ventricles, with greater benefit seen at or near 100 percent biventricular pacing. The need for nearly 100 percent biventricular pacing can cause a significant battery drain and is usually the major determinant of battery longevity.

“The results of this study aren’t surprising to us. In fact, performance reviews of our CRT-Ds have validated their industry-leading five-year survival probability,^[vii]” said Joe Fitzgerald, president, Cardiac Rhythm Management, Boston Scientific. “We offer CRT-Ds and ICDs designed to be the world’s longest lasting, with nearly double the battery capacity of some other available models, and we are proud of the independent recognition our innovative products continue to receive in the medical community.”

The study, Battery Longevity in Cardiac Resynchronization Therapy Implantable Cardioverter Defibrillators, was sponsored exclusively by University of Pittsburgh Medical Center. The study was conducted under the leadership of principal investigator Samir Saba, M.D., chief, cardiovascular electrophysiology, University of Pittsburgh Medical Center.

[i] Hauser; JACC 2005; 45;2022-5
[ii] Lindenfeld J, Hayes D, Varma N, Jones P, Wold N, Saxon L. Mortality of Patients with Heart Failure and Reduced Ejection Fraction (HFrEF) Who Receive Either ICD or CRT-D has Improved Yearly since 2003: The ALTITUDE Registry. Heart Failure Society of America, Presented at 2013 Annual Meeting.
[iii] Gould PA, Gula LJ, Campagne, J Healey, JS, Cameron D, et al. Outcome of advisory implantable cardioverter-defibrillator replacements: One year follow-up. Heart Rhythm 2008; 5: 1675-1681.
[iv] Bristow MR, Saxon LA, Boehmer J, Krueger S, Kass DA, De Marco T et al. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med 2004;350:2140–50.
[v] Cleland JG, Daubert JC, Erdmann E, Freemantle N, Gras D, Kappenberger L et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. NEnglJ Med 2005;352:1539–49.
[vi] Moss AJ, Hall WJ, Cannom DS, Klein H, Brown MW, Daubert JP et al. Cardiac-resynchronization therapy for the prevention of heart-failure events. N Engl J Med 2009;361:1329–38.
[vii] Boston Scientific CRM Product Performance Report, Q3 2013, COGNIS CRT-D.