Trends in Hospitalization for the Implantation of Cardioverter-Defibrillators in the United States, 1990–2005

Implantable cardioverter-defibrillators were first approved for use in the United States in 1985. Their efficacy in improving the survival of patients at risk for sudden cardiac death has been shown, and the number of patients eligible for ICDs has increased. Using data from the National Hospital Discharge Survey (NHDS), hospitalizations for the implantation of ICDs were identified and age- and gender-specific rates and trends in hospitalizations for ICDs during the period from 1990 to 2005 were estimated. From 1990 to 2005, the estimated number of hospitalizations for the implantation of ICDs increased from 5,600 to >108,000 for the total United States population, and the estimated annual rate of hospitalizations for the implantation of ICDs increased 10-fold. The rate of ICD procedures was substantially greater in men than women, and the rate increased significantly with age, although there was no increase in ICD use in patients aged ≥75 years. In conclusion, as the list of clinical indications and insurance coverage for ICD use expand, continued surveillance to monitor trends in the use of ICDs is warranted.