Figure 1
Study flow illustrating patient recruitment and ICD acquisition.
Table 1
Demographic and clinical characteristics of ICD Recipients in comparison with Non-Recipients.
| ICD IN SITU | P VALUE | |||||
|---|---|---|---|---|---|---|
| YES | NO | |||||
| (n = 69) | (n = 137) | |||||
| Age (years) (median [IQR]) | 61.3 [53.9, 66.4] | 62.2 [53.7, 71.7] | 0.431 | |||
| Gender (Male) | 55 | 79.7% | 94 | 68.6% | 0.101 | |
| Ethnicity | Black | 55 | 79.7% | 125 | 91.2% | 0.019 |
| Others | 14 | 20.3% | 12 | 8.8% | ||
| Residence (n = 187) | Rural | 6 | 8.7% | 25 | 18.2% | 0.031 |
| Urban | 62 | 89.9% | 94 | 68.6% | ||
| Primary cause of Heart Failure (n = 203) | Ischemic CMP | 42 | 63.6% | 62 | 45.3% | 0.014 |
| Non-Ischemic CMP | 24 | 36.4% | 75 | 54.7% | ||
| Left Ventricle EF (Baseline) | 30.0 [20.0, 35.0] | 25.0 [15.0, 30.0] | 0.003 | |||
| New York Heart Association Class | I | 7 | 10.1% | 22 | 16.1% | 0.241 |
| II | 34 | 49.3% | 74 | 54.0% | ||
| III | 28 | 40.6% | 41 | 29.9% | ||
| History of syncope (n = 200) | 14 | 20.3% | 4 | 3.1% | <0.001 | |
| Ventricular arrhythmia (n = 197) | 21 | 30.4% | 5 | 3.9% | <0.001 | |
| Comorbidities | Diabetes Mellitus | 20 | 29.0% | 62 | 45.3% | 0.34 |
| Hypertension | 34 | 49.3% | 85 | 62% | 0.1 | |
| Cancer | 4 | 5.8% | 7 | 5.1% | 1.0 | |
| Previous stroke | 4 | 5.8% | 9 | 6.6% | 1.0 | |
| Chronic kidney disease | 8 | 11.6% | 31 | 22.6% | 0.062 | |
| Dementia | 0 | 0.0% | 2 | 1.5% | 0.552 | |
| HIV | 1 | 1.4% | 2 | 1.5% | 1.0 | |
| Primary physician | General Cardiologist | 65 | 94.2% | 115 | 83.9% | 0.045 |
| Non-Cardiology Physician | 4 | 5.8% | 22 | 16.1% | ||
| Mode of payment | Cash Paying | 44 | 63.8% | 72 | 52.6% | 0.139 |
| Insurance | 52 | 75.4% | 84 | 61.3% | 0.119 | |
| Type of Insurance | NHIF | 8 | 11.6% | 26 | 19.0% | 0.233 |
| Private | 44 | 63.8% | 58 | 42.3% | 0.005 | |
Table 2
ICD placement data.
| NUMBER OF PATIENTS | PERCENTAGE OF PATIENTS | |
|---|---|---|
| ICD Recipients | 69 | 33.5% |
| Type of device | ||
| ICD | 44 | 63.8% |
| CRT-D | 25 | 36.2% |
| Type of ICD device | ||
| Single Chamber | 20 | 45.5% |
| Dual Chamber | 24 | 54.5% |
| MRI Compatible | 53 | 76.8% |
| Complications related to ICD procedure | 6 | 8.7% |
| Complications | ||
| Pneumothorax | 1 | 1.4% |
| Lead Displacement | 4 | 5.8% |
| Infection | 1 | 1.4% |
Table 3
Documented reasons for ICD refusal.
| DOCUMENTED REASONS FOR ICD REFUSAL (n = 88) | NUMBER OF PATIENTS | PERCENTAGE OF PATIENTS |
|---|---|---|
| Most common reasons | ||
| Unable to pay for the device | 66 | 75.0% |
| Concerned of risks | 3 | 3.4% |
| Fear of device procedure | 16 | 18.2% |
| Does not believe in ICD | 4 | 4.5% |
| Other | 5 | 5.7% |
| Other reasons | ||
| Awaiting EF improvement | 2 | 2.3% |
| Dementia | 1 | 1.1% |
| Need more time to decide | 2 | 2.3% |
Table 4
ICD Uptake in different populations.
| AUTHOR | YEAR | COUNTRY | POPULATION STUDIED | ICD UPTAKE |
|---|---|---|---|---|
| Bernier et al | 2019 | Canada | PP in ischemic and non-ischemic CMP. | 36% |
| Varwani et al | 2018 | Kenya | PP and SP post-acute myocardial infarction. | 35.7% |
| Lin Zhang et al | 2015 | USA | PP in ischemic and non-ischemic CMP. | 43% |
| Lyons et al | 2014 | Canada | PP in ischemic and non-ischemic CMP. | 59–68% |
| Mehra et al | 2012 | USA | PP in both Ischemic and Non-Ischemic CMP. | 64% |
| LaPointe et al | 2011 | USA | PP and SP in ischemic and non-ischemic CMP. | 59% |
[i] PP, Primary prevention; SP, Secondary Prevention; CMP, Cardiomyopathy.