ALTITUDE: Highest survival rates ever reported in patients with ICDs or CRT-Ds

Study also found that inappropriate shock therapy is still a clinical issue.

Heart Rhythm Society's 30th Annual Scientific Sessions

Study results presented at Heart Rhythm 2009 show survival rates exceeding prior data from other pivotal clinical trials for patients with an implantable cardioverter defibrillator or a cardiac resynchronization therapy device.

Researchers for the ALTITUDE trial, an observational, prospective study that reported mortality outcomes in ICD and CRT-D recipients, utilized mortality data from 85,999 patients of a remote monitoring system (Latitude Communicator, Boston Scientific). The researchers also measured the incidence of appropriate and inappropriate shock therapies in the same cohort.

After a five-year period, ALTITUDE results showed ICD survival rates of 91.8% among 47,032 patients and CRT-D survival rates of 78% among 38,967 patients. Shock was associated with decreased survival for both patients with ICDs and CRT-Ds, with the five-year incidence of shock reported at 35.5% for patients ICDs and 34.5% for those with CRT-Ds (P<.0001). Shocks were determined as appropriate among 57% of patients and inappropriate in 43%.

Determination of the clinical and economic value of ICD and CRT-D therapies should be based upon clinical trial data, certainly, but should also include larger datasets that reflect current practice and contemporary device follow-up and management,” said Leslie A. Saxon, MD, professor of clinical medicine at University of Southern California Keck School of Medicine, Los Angeles, during her presentation. “This type of network data dealing with an exponential increase in the number of patients evaluated will play a major role in the kind of device used…” – by Judith Rusk

For more information:

Saxon L. LBCT I. Presented at: Heart Rhythm 2009; May 13-16, 2009; Boston.

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