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, K T N Breeman Amsterdam University Medical Centre , Amsterdam , Netherlands (The) Search for other works by this author on: Oxford Academic R E Knops Amsterdam University Medical Centre , Amsterdam , Netherlands (The) Search for other works by this author on: Oxford Academic M D Van Der Stoel Netherlands Heart Registration , Utrecht , Netherlands (The) Search for other works by this author on: Oxford Academic L V A Boersma St Antonius Hospital , Nieuwegein , Netherlands (The) Search for other works by this author on: Oxford Academic S C Yap Erasmus University Medical Centre , Rotterdam , Netherlands (The) Search for other works by this author on: Oxford Academic L Van Erven Leiden University Medical Center , Leiden , Netherlands (The) Search for other works by this author on: Oxford Academic V F Van Dijk St Antonius Hospital , Nieuwegein , Netherlands (The) Search for other works by this author on: Oxford Academic A H Maass University Medical Center Groningen , Groningen , Netherlands (The) Search for other works by this author on: Oxford Academic A A M Wilde Amsterdam University Medical Centre , Amsterdam , Netherlands (The) Search for other works by this author on: Oxford Academic F V Y Tjong Amsterdam University Medical Centre , Amsterdam , Netherlands (The) Search for other works by this author on: Oxford Academic
On behalf of the device registration committee of the Netherlands Heart Registration
Funding Acknowledgements: Type of funding sources: None.
Author Notes
EP Europace, Volume 26, Issue Supplement_1, May 2024, euae102.701, https://doi.org/10.1093/europace/euae102.701
Published:
24 May 2024
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K T N Breeman, R E Knops, M D Van Der Stoel, L V A Boersma, S C Yap, L Van Erven, V F Van Dijk, A H Maass, A A M Wilde, F V Y Tjong, Trends in adoption of extravascular cardiac implantable electronic devices: the Dutch cohort, EP Europace, Volume 26, Issue Supplement_1, May 2024, euae102.701, https://doi.org/10.1093/europace/euae102.701
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Abstract
Introduction
Conventional implantable cardioverter-defibrillators (ICDs) and pacemakers carry a risk of mainly pocket- and lead-related complications. To avoid these complications, extravascular devices (EVDs) have been developed, such as the subcutaneous ICD (S-ICD) and leadless pacemaker (LP). However, data on the actual adoption of EVDs for patient or center characteristics is lacking.
Purpose
To assess real-world nationwide trends in adoption of EVDs in the Netherlands.
Methods
Using the Netherlands Heart Registration, all consecutive patients with a de novo S-ICD or conventional single-chamber ICD implantation between 2012-2020, or with a de novo LP or conventional single-chamber pacemaker implantation between 2014-2020 were included. Trends in adoption of EVDs are described for different patient and hospital characteristics (tertiles of device-implanting volume and whether cardiothoracic surgery back-up was available). Differences between patients with EVDs and non-EVDs and differences between implanting centers of EVDs and non-EVDs were tested for by Student’s T-test, Chi-square and Fisher’s exact test. Trends in adoption over time were calculated with linear and logistic regression analysis.
Results
From 2012-2020, 2190 S-ICDs and 10683 conventional ICDs were implanted; from 2014-2020, 712 LPs and 11103 conventional pacemakers were implanted. The general adoption of both increased (S-ICDs, 8% to 21%; LPs, 1% to 8%), but the increase seems to reach a plateau (Fig. 1). S-ICD recipients were younger than conventional ICD recipients (p<0.001) and more likely to be female (p<0.001); LP recipients were younger than conventional pacemaker recipients (p<0.001) and more likely to be male (p=0.03). Both S-ICDs and LPs were mainly implanted in high-volume centers with thoracic surgery on-site (Fig. 2).
Conclusions
In this nationwide study we observed a relative quick adoption of innovative EVDs with a plateau after approximately 4 years. The relative adoption of S-ICDs is especially high in younger patients. EVDs are overall mainly implanted in high-volume centers with cardiothoracic surgery available. As LPs can only be implanted in centers with cardiothoracic surgery in the Netherlands, this may have limited its adoption.
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Author notes
On behalf of the device registration committee of the Netherlands Heart Registration
Funding Acknowledgements: Type of funding sources: None.
© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.
This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.
Topic:
- artificial cardiac pacemaker
- implantable defibrillators
- lipopolysaccharides
- netherlands
- heart
- thoracic surgery procedures
- implantable defibrillator insertion
- van der woude syndrome
- medical devices
- cardiothoracic surgery
- subcutaneous icd
- cardiovascular implantable electronic device
- single chamber pacemaker
Issue Section:
Arrhythmias and Device Therapy > Arrhythmias, General > Treatment
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