{"id":1531,"date":"2014-05-29T00:00:00","date_gmt":"2014-05-29T04:00:00","guid":{"rendered":"https:\/\/icesontario.wpengine.com\/journal-articles\/greater-mortality-risk-among-patients-with-delayed-follow-up-after-implantable-cardioverter-defibrillator-procedures\/"},"modified":"2023-06-14T19:39:14","modified_gmt":"2023-06-14T23:39:14","slug":"greater-mortality-risk-among-patients-with-delayed-follow-up-after-implantable-cardioverter-defibrillator-procedures","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/greater-mortality-risk-among-patients-with-delayed-follow-up-after-implantable-cardioverter-defibrillator-procedures\/","title":{"rendered":"Greater mortality risk among patients with delayed follow-up after implantable cardioverter defibrillator procedures"},"content":{"rendered":"

Background<\/strong> — Substantial numbers of deaths occur among implantable cardioverter defibrillator (ICD) recipients. Timely follow-up after ICD implantation may improve patient outcomes. The researchers' objective was to examine follow-up care and outcomes among patients undergoing ICD implantation. <\/p>\n

Methods<\/strong> — The researchers compared patient characteristics and outcomes of those with late (>12 weeks) vs. early defibrillator clinic follow-up after ICD implantation in the Ontario ICD Database from 2007-2011. The researchers examined the impact of post-implant ICD clinic follow-up visits compared with primary care physician tracer on mortality outcomes using time-varying covariate analysis. <\/p>\n

Results <\/strong>— Among 8096 ICD recipients (age 64.6 ± 12.6 years), 1145 (14%) received delayed follow-up. Patients with early ICD clinic follow-up experienced reduced risk of all-cause mortality, with hazards ratio [HR] 0.69 (95%CI; 0.50–0.95, p=0.023) adjusted for clinical factors, post-discharge primary care visits, and distance to follow-up center. Early ICD clinic follow-up was associated with a reduction in out-of-hospital death with adjusted HR 0.52 (95%CI; 0.36–0.76, p=0.001) but not with a significant change in cardiovascular hospitalizations. In a tracer analysis, early primary care physician follow-up was associated with a nonsignificant trend towards increased mortality with adjusted HR 1.48 (95%CI; 0.97–2.25, p=0.072). Reduced eGFR, secondary prevention or replacement devices, myocardial ischemia, smoking, and greater geographic distance to the implanting center increased the odds of delayed follow-up.<\/p>\n

Conclusions<\/strong> — After device implantation, early defibrillator clinic follow-up was associated with reduced risk of all-cause and out-of-hospital death compared to those experiencing delayed follow-up. This study examines the relationship between delayed follow-up (>12 weeks) at a specialized implantable cardioverter defibrillator (ICD) clinic and outcomes in patients receiving ICDs. Among 8096 ICD recipients, 1145 patients (14%) received delayed follow-up. Patients experiencing early follow-up after ICD implantation exhibited reduced risk of all cause mortality, and reduced out-of-hospital death without a significant change in cardiovascular hospitalizations.<\/p>\n","protected":false},"excerpt":{"rendered":"

Background — Substantial numbers of deaths occur among implantable cardioverter defibrillator (ICD) recipients. Timely follow-up after ICD implantation may improve patient outcomes. The researchers' objective was to examine follow-up care and outcomes among patients undergoing ICD implantation. Methods — The researchers compared patient characteristics and outcomes of those with late (>12 weeks) vs. early defibrillator clinic follow-up […]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[24,40],"migration-helper-qa-sample-set":[],"class_list":["post-1531","journal_article","type-journal_article","status-publish","hentry","topic-acute-and-emergency-services","topic-cardiovascular-disease"],"acf":{"citation":"Laksman ZW, Krahn AD, Dorian P, Simpson CS, Crystal E, Healey JS, Khaykin Y, Wang X, Lee DS. Can J Cardiol.<\/em> 2014; 30(6):598–605.","source_url":"","ices_scientist":[1290,1363],"site":[6733],"research_program":[6742],"news_release":[7332],"journal_article":[],"atlas":[],"research_report":[],"infographic":[],"video":[],"downloads":null,"links":null,"sitecore_item_id":"7FE0FE7D-6EF2-43D6-9E11-610075BE5197","sitecore_item_name":"Greater-mortality-risk-among-patients-with-delayed-follow-up-after-ICD","sitecore_field_values":"{\n \"Title\": \"Greater mortality risk among patients with delayed follow-up after implantable cardioverter defibrillator procedures\",\n \"Short title\": \"Greater mortality risk among patients\",\n \"Summary\": \"Substantial numbers of deaths occur among implantable cardioverter defibrillator (ICD) recipients. Timely follow-up after ICD implantation may improve patient outcomes.\",\n \"Citation\": \"

Laksman ZW, Krahn AD, Dorian P, Simpson CS, Crystal E, Healey JS, Khaykin Y, Wang X, Lee DS. Can J Cardiol.<\/em> 2014; 30(6):598–605.<\/p>\",\n \"Abstract\": \"

Background<\/strong> — Substantial numbers of deaths occur among implantable cardioverter defibrillator (ICD) recipients. Timely follow-up after ICD implantation may improve patient outcomes. The researchers' objective was to examine follow-up care and outcomes among patients undergoing ICD implantation. <\/p>n

Methods<\/strong> — The researchers compared patient characteristics and outcomes of those with late (>12 weeks) vs. early defibrillator clinic follow-up after ICD implantation in the Ontario ICD Database from 2007-2011. The researchers examined the impact of post-implant ICD clinic follow-up visits compared with primary care physician tracer on mortality outcomes using time-varying covariate analysis. <\/p>n

Results <\/strong>— Among 8096 ICD recipients (age 64.6 ± 12.6 years), 1145 (14%) received delayed follow-up. Patients with early ICD clinic follow-up experienced reduced risk of all-cause mortality, with hazards ratio [HR] 0.69 (95%CI; 0.50–0.95, p=0.023) adjusted for clinical factors, post-discharge primary care visits, and distance to follow-up center. Early ICD clinic follow-up was associated with a reduction in out-of-hospital death with adjusted HR 0.52 (95%CI; 0.36–0.76, p=0.001) but not with a significant change in cardiovascular hospitalizations. In a tracer analysis, early primary care physician follow-up was associated with a nonsignificant trend towards increased mortality with adjusted HR 1.48 (95%CI; 0.97–2.25, p=0.072). Reduced eGFR, secondary prevention or replacement devices, myocardial ischemia, smoking, and greater geographic distance to the implanting center increased the odds of delayed follow-up.<\/p>n

Conclusions<\/strong> — After device implantation, early defibrillator clinic follow-up was associated with reduced risk of all-cause and out-of-hospital death compared to those experiencing delayed follow-up. This study examines the relationship between delayed follow-up (>12 weeks) at a specialized implantable cardioverter defibrillator (ICD) clinic and outcomes in patients receiving ICDs. Among 8096 ICD recipients, 1145 patients (14%) received delayed follow-up. Patients experiencing early follow-up after ICD implantation exhibited reduced risk of all cause mortality, and reduced out-of-hospital death without a significant change in cardiovascular hospitalizations.<\/p>\",\n \"Keywords\": \"{92E2791D-5DAB-4244-8A85-434D524D9A12}|{8DA96C16-E06B-4D90-802D-73D8A7C9612E}|{E93E0287-ACCB-4952-BB98-00EF52815525}\",\n \"Related Products\": \"

News Release<\/h2>rn

Early followup care after ICD procedure associated with 31 per cent reduction in death: ICES study<\/a><\/h3>rn

IN THE NEWS<\/a><\/h2>rn

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