Patient characteristics, predictors and outcome of pacemaker patients upgraded to an implantable cardioverter defibrillator.

Baldinger, Samuel; Burren, Désirée; Noti, Fabian; Servatius, Helge; Seiler, Jens; Madaffari, Antonio; Asatryan, Babken; Tanner, Hildegard; Reichlin, Tobias; Häberlin, Andreas; Roten, Laurent (2024). Patient characteristics, predictors and outcome of pacemaker patients upgraded to an implantable cardioverter defibrillator. Pacing and clinical electrophysiology, 47(6), pp. 853-861. Wiley 10.1111/pace.14988

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Pacemaker (PM) patients may require a subsequent upgrade to an implantable cardioverter defibrillator (ICD). Limited data exists on this patient population. We sought to characterize this population, to assess predictors for ICD upgrade, and to report the outcome.


From our prospective PM and ICD implantation registry, all patients who underwent PM and/or ICD implantations at our center were analyzed. Patient characteristics and outcomes of PM patients with subsequent ICD upgrade were compared to age- and sex-matched patients with de novo ICD implantation, and to PM patients without subsequent upgrade.


Of 1'301 ICD implantations, 60 (5%) were upgraded from PMs. Median time from PM implantation to ICD upgrade was 2.6 years (IQR 1.3-5.4). Of 2'195 PM patients, 28 patients underwent subsequent ICD upgrades, corresponding to an estimated annual incidence of an ICD upgrade of at least 0.33%. Lower LVEF (p = .05) and male sex (p = .038) were independent predictors for ICD upgrade. Survival without death, transplant and LVAD implantation were worse both for upgraded ICD patients compared to matched patients with de novo ICD implantation (p = .05), as well as for PM patients with subsequent upgrade compared to matched PM patients not requiring an upgrade (p = .036).


One of 20 ICD implantations are upgrade of patients with a PM. At least one of 30 PM patients will require an ICD upgrade in the following 10 years. Predictors for ICD upgrade are male sex and lower LVEF at PM implantation. Upgraded patients have worse outcomes.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > Faculty Institutions > sitem Center for Translational Medicine and Biomedical Entrepreneurship
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Baldinger, Samuel Hannes, Noti, Fabian, Servatius, Helge Simon (B), Seiler, Jens, Madaffari, Antonio, Asatryan, Babken, Tanner, Hildegard, Reichlin, Tobias Roman, Häberlin, Andreas David Heinrich, Roten, Laurent


600 Technology > 610 Medicine & health








Pubmed Import

Date Deposited:

25 Apr 2024 10:29

Last Modified:

19 Jun 2024 00:15

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

implantable cardioverter defibrillator mortality pacemaker risk factors upgrade




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