Device Longevity in Implantable Cardioverter-Defibrillator Therapy
Summary
Implantable cardioverter-defibrillators (ICDs) are critical for preventing sudden cardiac death in high-risk patients, yet their therapeutic value is closely tied to device longevity. Battery depletion and mechanical wear necessitate periodic generator replacement, which carries procedural risks, infection potential and increased health-care costs. Longevity is influenced by battery chemistry, device programming, pacing modes and energy requirements for therapy delivery. Technological innovations – including high-energy lithium-based chemistries, advanced power management algorithms and leadless sensing configurations – aim to extend service life while preserving therapeutic efficacy. Improvements in device design have progressively increased median battery life from under five years in early models to over ten years in many contemporary systems. Nevertheless, substantial variability remains across manufacturers and device types, and real-world performance data are essential for optimising device selection and follow-up strategies on a global scale.
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Device Longevity in Implantable Cardioverter-Defibrillator Therapy publication trend
The graph below shows the total number of articles in device longevity in implantable cardioverter-defibrillator therapy across all publications each year (not limited to Nature Index journals).
Technical terms
Battery chemistry: The specific lithium-based composition (e.g., LiMnO₂, LiSVO/CFₓ) that determines energy density and discharge profile.
Elective Replacement Indicator (ERI): A device-generated alert signalling that battery voltage has fallen below a predefined threshold and generator replacement should be scheduled.
Cardiac resynchronization therapy defibrillator (CRT-D): A combined device providing both biventricular pacing to improve cardiac synchrony and defibrillation capability to terminate life-threatening arrhythmias.
References
- Longevity of implantable cardioverter defibrillators: a comparison among manufacturers and over time. EP Europace (2015).
- Reliability and longevity of implantable defibrillators. Journal of Interventional Cardiac Electrophysiology (2021).
- “Real-world” analysis of battery longevity of implantable cardioverter-defibrillators: an in-depth analysis of a prospective defibrillator database. BMC Cardiovascular Disorders (2023).
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