Abstract 12188: Utilization Rates of Primary Prevention Implantable Cardioverter-Defibrillators: A 2012 Calculation for a Midwestern Health Referral Region

Background: Database studies suggest that utilization rates (UR) of implantable cardioverter-defibrillators (ICD) for primary prevention of sudden cardiac death (PPSCD) are highly variable, with racial and gender discrepancies previously observed. However, because rates vary by referral regions and few studies have utilized comprehensive review of source documents (charts), the ICD UR in the community remains unclear. We sought to establish the ICD UR in central Indiana. Methods and Results: We queried electronic medical records for patients with left ventricular ejection fraction (LVEF) ≤ 0.35 between June 2011 and May 2012, which returned 1863 unique patients. The ICD UR is defined by x/(x+y), where x=PPSCD ICD’s utilized and y=patients with Class I indication but without ICD implantation during the same time period. We found 1672 without (Cohort A) and 191 with (Cohort B) procedure code 37.94 (Implantation or replacement of ICD). To identify those patients eligible for ICD, we manually reviewed a strat...