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Need and evolution of need for device therapy in a community heart failure population
Author(s) -
Sulaiman Habitha M.,
O'Loughlin Christina,
Daly Marie,
Conlon Carmel,
Ledwidge Mark,
McCaffrey Dermot,
McDonald Kenneth
Publication year - 2008
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2008.04.010
Subject(s) - medicine , heart failure , population , intensive care medicine , cardiology , physical therapy , environmental health
Background New guidelines for implantable cardiac defibrillators (ICD) and cardiac resynchronisation therapy (CRT) have expanded the potential use for device therapy. The implications of this on a community heart failure (HF) population are unknown. Aim To assess the need for device therapy and the change in need over time. Methods We reviewed device need in a community HF population using ESC guidelines. Change in need was assessed by comparing data between an annual visit called TP2 and an earlier visit called TP1. Patients'need and change in need between TP1 and TP2 was determined. Results 210 patients were included; mean age 70±12 years, 67% male and 54% ischaemic. At TP1, 34% of patients were suitable for ICD and 3% for CRT. At TP2, 22% and 1% were suitable respectively. Of those suitable for ICD at TP1, 19% lost the need at TP2; in addition 9% of patients unsuitable for ICD at TP1 had acquired the need by TP2. Fifty five percent of patients were unsuitable for ICD at either time point, and 16% were suitable at both time points. CRT need was negligible but also noted to change. Conclusion ICD need is substantial in a community HF population, but CRT need is limited. ICD need changes significantly. Identifying those likely to change their need may optimise ICD use.