• Bianca Blanch, Luise P Lago, Raymond Sy, Phillip J Harris, Christopher Semsarian, and Jodie Ingles.
• Agnes Ginges Centre for Molecular Cardiology, Centenary Institute, Sydney, NSW j.ingles@centenary.org.au.
• Med. J. Aust. 2018 Aug 6; 209 (3): 123-129.

ObjectivesTo quantify the number of implantable cardioverter-defibrillator (ICD) procedures in Australia by year, patient age and sex, and to estimate age group-specific population rates and the associated costs. Design, setting: Retrospective observational study; analysis of Australian National Hospital Morbidity Database hospital procedures data.ParticipantsPatients with an ICD insertion, replacement, adjustment, or removal procedure code, July 2002 - June 2015.Main Outcome MeasuresNumber of ICD procedures by procedure year, patient age (0-34, 35-69, 70 years or more) and sex; age group-specific population procedure rates; number of procedures associated with complications.ResultsThe number of ICD procedures increased from 1844 in 2002-03 to 6504 in 2014-15; more than 75% of procedures were in men. In 2014-15, the ICD insertion rate for people aged 70 years or more was 78.1 per 100 000 population, 22 per 100 000 for those aged 35-69 years, and 1.40 per 100 000 people under 35. The reported complication rate decreased from 45% in 2002-03 to 19% in 2014-15, partly because of a change in the coding of complications. The number of removals corresponded to at least 4% of the number of insertions each year. The aggregate cost of hospitalisations with an ICD procedure during 2011-14 was $445 644 566.ConclusionICD procedures are becoming more frequent in Australia, particularly in people aged 70 or more. Patterns of care associated with ICD therapy, particularly patient- and hospital-related factors associated with adverse events, should be investigated to better understand and improve patient outcomes.

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