In-hospital and long-term prognosis in patients after implantation of implantable cardioverter-defibrillators and cardiac resynchronization therapy: 10-year results of the SILCARD registry

Introduction During the last 20 years, there has been a considerable increase in the number of implanted implantable cardioverter‑defibrillator (ICD) and cardiac resynchronization therapy (CRT) devices. However, there have been only single reports on clinical events, including rehospitalizations, in the long‑term follow‑up.
Objectives We analyzed the baseline clinical characteristics, medical procedures used, and complications of patients with implantation of an ICD or CRT device. Moreover, we analyzed the causes of rehospitalization and the types of treatment used in the 12‑month follow‑up.
Patients and methods Out of 1 208 440 hospitalizations of patients with cardiovascular diseases included in the SILCARD registry, hospitalizations with an ICD‑9 code for an ICD or CRT device implantation between 2006 and 2016 were selected.
Results The analysis included 12 147 patients with an ICD or CRT device. The total number of hospitalizations was 14 552. Over the years, a significant increase in the number of implanted devices and a higher percentage of CRT defibrillators was observed. Before the implantation, approximately 48.2% of patients underwent revascularization. In‑hospital and 12‑month mortality rates were 0.4% and 8.1%, respectively. Rehospitalizations due to cardiovascular causes were reported for approximately 40.3% of patients, with a significant reduction in the analyzed period. The most frequent cause of rehospitalization was heart failure (51.4%), while stable coronary artery disease and acute coronary syndromes constituted approximately 16% of the causes. In the 12‑month follow‑up, nearly every tenth patient was subjected to coronary angiography. Approximately 5% of patients required revascularization.
Conclusions The relatively high rates of hospital readmissions and their causes indicate the need for a comprehensive care of patients before implantation of ICD or CRT devices and after discharge.