RESEARCH ARTICLE

Factors Influencing Utilization of the Primary Prevention Implantable Defibrillator Lin Zhang1☯, Kumar Narayanan2☯, Harpriya Chugh2, Takahiro Shiota2, Zhi-Jie Zheng1, Sumeet S Chugh2* 1 Shanghai Jiaotong University School of Public Health, Shanghai, China, 2 The Heart Institute, CedarsSinai Medical Center, Los Angeles, California, United States of America ☯ These authors contributed equally to this work. * [email protected]

Abstract Background

OPEN ACCESS Citation: Zhang L, Narayanan K, Chugh H, Shiota T, Zheng ZJ, Chugh SS (2015) Factors Influencing Utilization of the Primary Prevention Implantable Defibrillator. PLoS ONE 10(3): e0121515. doi:10.1371/journal.pone.0121515 Academic Editor: Utpal Sen, University of Louisville, UNITED STATES Received: November 27, 2014 Accepted: February 2, 2015 Published: March 20, 2015 Copyright: © 2015 Zhang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: All data underlying the findings in this study are freely available in the paper. Funding: Dr. Chugh holds the Pauline and Harold Price Chair in Cardiac Electrophysiology Research at the Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist.

A growing literature suggests underutilization of the primary prevention implantable cardioverter-defibrillator (ICD); thus, factors influencing utilization need to be understood. We performed a comprehensive assessment of patient characteristics and health insurance status among subjects eligible for primary prevention ICD in a tertiary care center.

Methods From among a group of patients who met criteria for primary prevention ICD based on left ventricular dysfunction (LVEF  35%), ICD recipients (n = 110) were compared to ICD nonrecipients (n = 110) to identify determinants of ICD implantation. We evaluated demographics, clinical profile including Charlson Comorbidity Index [CCI, categorized as low (3) or high (>3)] and health insurance status.

Results ICD recipients were younger (62.1±15.0 vs. 68.0±18.2; P = 0.01), with more males (80% vs. 65.5%; P = 0.01), higher NYHA class (II/III: 75.5% vs. 40.2%; P

Factors influencing utilization of the primary prevention implantable defibrillator.

A growing literature suggests underutilization of the primary prevention implantable cardioverter-defibrillator (ICD); thus, factors influencing utili...
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