Battery Longevity in Modern Implantable Cardioverter-Defibrillators and Cardiac Resynchronization Therapy-Defibrillators

Background

Battery longevity in high-voltage devices (HVDs), specifically implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy-defibrillators (CRT-Ds), is critical for reducing the frequency of generator replacements, minimizing procedural risks, and enhancing patient outcomes. Despite technological advancements, significant variability in battery performance remains among the major manufacturers. This study aimed to evaluate the battery longevity among ICDs and CRT-Ds from the major manufacturers implanted at a single institution and identify the factors influencing battery depletion.

Methods

We conducted a retrospective analysis of 353 patients implanted with HVDs (63 Abbott, 150 Boston Scientific, 140 Medtronic) at Hokkaido University Hospital between 2012 and 2021. Kaplan–Meier curves and Cox proportional hazards models were used to analyze the device longevity, with a primary endpoint of the time to battery depletion, defined by the elective replacement indicator. A multivariate analysis adjusted for the potential confounders.

Results

Boston Scientific devices exhibited a significantly longer battery life than Abbott and Medtronic devices (p < 0.001), with a 6-year replacement-free survival of 99% for ICDs and 93% for CRT-Ds. A multivariate analysis identified the device manufacturer, device type (ICD vs. CRT-D), and ventricular pacing rate as independent predictors of battery depletion (p < 0.001).

Conclusion

Battery longevity differed significantly by the manufacturer, which may influence device selection. Devices with a longer battery life may help reduce the replacement frequency and could potentially contribute to improved patient outcomes and cost-effectiveness.