Real-World Data Shows Medtronic ICDs Can Help Prevent Sudden Cardiac Death

Medtronic released results from two analyses showing the survival benefits and reduced life-threatening cardiac events with use of implantable cardioverter-defibrillators (ICDs) at this year’s European Society of Cardiology Congress.
 
The data demonstrated real-world evidence backing use of Medtronic ICDs for indicated patients, reinforcing findings from landmark ICD studies, but in a contemporary patient population. The company said ICDs are still underutilized for patients who are medically indicated for them.
 
This analysis aimed to determine current impact of ICDs on survival in patients who haven’t previously experienced a life-threatening arrhythmia (primary prevention). It used de-identified, real-world, contemporary data from 2012 through 2020. 25,296 patients had a primary prevention ICD indication, of which 2,118 (8.4%) received an ICD within a year. Patients with an ICD had a 24.3% lower risk of death than those with similar characteristics who didn’t receive an ICD. 
 
“ICD therapy has had a number of landmark clinical trials, dating back nearly two decades; over the years, both medical technology and optimal medical therapy have continued to evolve. These analyses show that today’s ICDs continue to positively impact patient survival – in tandem with modern heart failure medications,” Prof. Auricchio, Deputy Head of Cardiology and Director of the Clinical Electrophysiology Unit at Fondazione Cardiocentro Ticino, Lugano, Switzerland and lead author of the two analyses, told the press.
 
The analysis examined incidence of ICD therapy after routine device replacement in patients who didn’t receive therapy from their first ICD. De-identified data on 10,742 patients from Medtronic’s CareLink database receiving a replacement device after 2012 through the present day was utilized—9,397 primary prevention patients and 1,345 secondary prevention patients. Time-to-first appropriate therapy [either shock and/or anti-tachycardia pacing (ATP) therapy] after ICD replacement was evaluated through seven years post-replacement.
 
At seven years, incidence of first appropriate therapy in primary prevention patients was 28% (17% shock and 24% ATP). For secondary prevention patients, the rates of first appropriate therapy were 24% (14% shock and 19% ATP).
 
Prof. Auricchio continued, “We should not assume that a primary or secondary prevention patient who didn’t receive therapy from their first ICD can go unprotected without a replacement device despite continuation of guideline-recommended pharmacological therapy. ICDs should continue to be offered as the gold standard for life-saving intervention for all indicated patients.”