Hospital readmission after transvenous cardioverter/defibrillator implantation - A single centre study

Aims Hospital readmission after implantation of cardioverter/defibrillators has a major impact on quality of life and cost-effectiveness in defibrilla tor patients. Rehospitalization has not been studied in large patient popul ations with modern transvenous defibrillation systems. Methods and Results We report on incidence, reasons, time in follow-up dura tion and predictors of hospital readmission in 180 patients after transveno us implantation of a cardioverter/defibrillator during a follow-up period o f 25 +/- 18 months. There were 156 readmissions in 79 patients with a 0.87 readmission rate per patient during the time followed, a 0.46 readmission r ate per patient-year of follow-up and a 0.38 readmission rate per patient-y ear of follow-up for cardiac reasons. The majority of readmissions was caus ed by multiple appropriate shock interventions (26%), battery depletion (19 %) and lead- and device-related complications (14%). The time to first hosp ital readmission was 12 +/- 9 months for arrhythmia-related and 20 +/- 16 m onths for other cardiac-related reasons (P<0.05): and could not be predicte d by clinical variables, respectively. The duration of rehospitalization wa s 14 +/- 15 days for cardiac-related reasons and 12 +/- 17 days far arrhyth mia-related reasons. Age >60 years was an independent predictor of rehospit alization time per patient-year of follow-up for both cardiac-related (P<0. 005) and arrhythmia-related reasons (P<0.05). Conclusion The rate of hospital readmission per patient-year of follow-up i s as high as 0.46 after implantation of a modern cardioverter/defibrillator . Rehospitalization time in such patients is significantly longer in the pa tient cohort >60 years. The majority of readmissions is caused by multiple appropriate shock treatments. Further studies are needed to systematically investigate strategies for the prevention of rehospitalization in modern IC D therapy. (Eur Heart J 2000; 21: 1186-1191) (C) 2000 The European Society of Cardiology.