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Online Appendix for the following February 23 JACC article
TITLE: Evaluation of Early Complications Related to De Novo Cardioverter
Defibrillator Implantation: Insights From the Ontario ICD Database
AUTHORS: Douglas S. Lee, Andrew D. Krahn, Jeffrey S. Healey, David Birnie, Eugene
Crystal, Paul Dorian, Christopher S. Simpson, Yaariv Khaykin, Douglas Cameron, Amir
Janmohamed, Raymond Yee, Peter C. Austin, Zhongliang Chen, Judy Hardy, Jack V. Tu
_____________________________________________________________________
APPENDIX 1. Participating Hospitals and Investigators in the Ontario ICD
Database
Defibrillator Implantation and Follow-up Sites: Hamilton Health Sciences Centre
(J.S. Healey), Kingston General Hospital (C.S. Simpson), London Health Sciences
Centre (A.D. Krahn, R. Yee), Rouge Valley Health System (A. Janmohammed), St.
Michael’s Hospital (I. Mangat, P. Dorian), Southlake Regional Health Centre (Y.
Khaykin), Sunnybrook Health Sciences Centre (E. Crystal), Toronto General Hospital (D.
Cameron), Trillium Health Centre (C. LeFeuvre), University of Ottawa Heart Institute (D.
Birnie)
Non-Implanting Defibrillator Follow-up Sites: Credit Valley Hospital (J. Cyriac), Grey
Bruce Health Services (M. Newton), Hotel Dieu Grace Hospital (A. Glanz), Kawartha
Cardiology Clinic (W. Hughes), St. Mary’s General Hospital (C. Rinne), Scarborough
General Hospital (E.G. Davies), Sudbury Regional Hospital (R. Labonte), Thunder Bay
Regional Health Sciences Centre (C. Lai)
APPENDIX 2. Univariate analysis for major complications
Major Complications
Age 61-80 vs. 60 yr
Age >80 vs. 60 yr
Women
Secondary vs. Primary prevention
Nonischemic vs. Ischemic CM
Other cardiac disease vs. Ischemic CM
Prior myocardial infarction
Prior PCI or CABG
Heart failure
NYHA class III-IV vs. I-II
Pre-existing pacemaker system
Atrial fibrillation
Diabetes
Hypertension
Chronic obstructive lung disease
ACE inhibitor or ARB
Beta-adrenoreceptor blocker
Loop diuretic
Anticoagulation, Aspirin or Clopidogrel
vs. None
Amiodarone vs. None
Class 1 or Other Class 3 AAD vs. None
QRS duration >140 vs. 140 msec
LVESD 45 vs. <45 mm
LVEDD 60 vs. <60 mm
LVEF 21-35 vs. >35%
LVEF 20 vs. >35%
LA size 45 vs. <45 mm
Serum creatinine >2.49 vs. 1.24 mg/dL
Serum creatinine 1.25-2.49 vs. 1.24
mg/dL
Serum Sodium 135 vs. >135 mEq/L
Hemoglobin >12.0 vs. 10.0 g/dL
Hemoglobin 10.1-12.0 vs. 10.0 g/dL
eGFR <30 vs. 90 mL/min/1.73 m2
eGFR 30-59 vs. 90 mL/min/1.73 m2,
eGFR 60-89 vs. 90 mL/min/1.73 m2,
Weight (per 10 lb)
New leads 2 vs. 1 or none
New leads 3 vs. 1 or none
Passive vs. active fixation RV lead
Dual vs. single coil RV lead
Dual-chamber ICD vs. Single-chamber
CRT-D vs. Single-chamber
Hazard Ratio
1.01
0.97
1.57
1.23
1.93
1.49
0.95
0.70
1.14
1.47
1.39
0.93
1.11
1.08
1.05
0.69
0.91
1.13
95% CI
0.71 - 1.44
0.44 - 2.15
1.09 - 2.26
0.86 - 1.75
1.14 - 3.27
0.92 - 2.41
0.68 - 1.33
0.49 - 0.99
0.81 - 1.61
1.04 - 2.08
0.77 - 2.52
0.64 - 1.35
0.77 - 1.61
0.77 - 1.51
0.63 - 1.77
0.46 - 1.03
0.58 - 1.44
0.80 - 1.59
p-value
0.96
0.95
0.016
0.25
0.015
0.11
0.76
0.04
0.45
0.029
0.27
0.71
0.57
0.66
0.84
0.071
0.68
0.48
1.43
1.07
3.34
1.44
1.57
0.99
1.07
0.98
1.03
1.14
0.88 - 2.30
0.70 - 1.62
1.06 - 10.53
1.03 - 2.02
1.12 -2.21
0.68 - 1.44
0.69 - 1.66
0.56 - 1.71
0.70 – 1.50
0.57 - 3.48
0.15
0.75
0.039
0.035
0.009
0.96
0.77
0.95
0.89
0.45
1.12
1.09
0.71
0.58
1.79
1.21
0.85
1.01
1.78
2.17
1.29
0.67
1.96
2.33
0.78 - 1.61
0.59 - 2.02
0.38 -1.32
0.28 -1.22
0.89 - 3.60
0.75 - 1.95
0.53 - 1.36
0.95 -1.07
1.21 - 2.63
1.38 - 3.40
0.68 - 2.46
0.21 - 2.10
1.29 - 2.98
1.51 - 3.59
0.55
0.78
0.27
0.15
0.10
0.43
0.51
0.70
0.004
<0.001
0.44
0.49
0.002
<0.001
AAD=antiarrhythmic drug, ACE=angiotensin converting enzyme, ARB=angiotensin
receptor blocker, CABG=coronary artery bypass graft surgery, CM=cardiomyopathy,
CRT-D=cardiac resynchronization defibrillator, eGFR=estimated glomerular filtration
rate, ICD=implantable cardioverter defibrillator, LA=left atrium, LVEDD=left ventricular
end-diastolic dimension, LVEF=left ventricular ejection fraction, LVESD=left ventricular
end-systolic dimension, NYHA=New York Heart Association, PCI=percutaneous
coronary intervention; To convert serum creatinine to SI units (mol/L), multiply by 88.4
APPENDIX 3. Univariate analysis for minor complications
Minor Complications
Age 61-80 vs. 60 yr
Age >80 vs. 60 yr
Women
Secondary vs. Primary prevention
Nonischemic vs. Ischemic CM
Other cardiac disease vs. Ischemic CM
Prior myocardial infarction
Prior PCI or CABG
Heart failure
NYHA class III-IV vs. I-II
Pre-existing pacemaker system
Atrial fibrillation
Diabetes
Hypertension
Chronic obstructive lung disease
ACE inhibitor or ARB
Beta-adrenoreceptor blocker
Loop diuretic
Anticoagulation, Aspirin or Clopidogrel
vs. None
Amiodarone vs. None
Class 1 or Other Class 3 AAD vs. None
QRS duration >140 vs. 140 msec
LVESD 45 vs. <45 mm
LVEDD 60 vs. <60 mm
LVEF 21-35 vs. >35%
LVEF 20 vs. >35%
LA size 45 vs. <45 mm
Serum creatinine >2.49 vs. 1.24 mg/dL
Serum creatinine 1.25-2.49 vs. 1.24
mg/dL
Serum Sodium 135 vs. >135 mEq/L
Hemoglobin >12.0 vs. 10.0 g/dL
Hemoglobin 10.1-12.0 vs. 10.0 g/dL
eGFR <30 vs. 90 mL/min/1.73 m2
eGFR 30-59 vs. 90 mL/min/1.73 m2,
eGFR 60-89 vs. 90 mL/min/1.73 m2,
Weight (per 10 lb)
New leads 2 vs. 1 or none
New leads 3 vs. 1 or none
Passive vs. active fixation RV lead
Dual vs. single coil RV lead
Dual-chamber ICD vs. Single-chamber
CRT-D vs. Single-chamber
Hazard Ratio
1.29
1.64
1.40
0.84
2.21
1.74
0.84
0.75
1.23
1.73
1.52
1.19
1.06
1.21
1.33
0.84
1.31
1.24
95% CI
0.92 - 1.80
0.88 - 3.08
1.00 - 1.96
0.60 - 1.18
1.35 - 3.61
1.10 - 2.74
0.62 - 1.14
0.55 - 1.03
0.90 - 1.67
1.27 - 2.35
0.91 - 2.54
0.86 - 1.63
0.76 - 1.48
0.89 - 1.64
0.86 - 2.04
0.58 - 1.23
0.82 - 2.09
0.91 - 1.68
p-value
0.13
0.12
0.051
0.32
0.002
0.017
0.26
0.073
0.20
<0.001
0.11
0.29
0.74
0.23
0.20
0.38
0.26
0.17
1.40
1.32
1.82
1.36
1.25
1.04
1.07
0.98
0.97
1.04
0.91 - 2.15
0.93 - 1.87
0.45 - 7.36
1.01 - 1.85
0.93 -1.69
0.73 -1.47
0.72 - 1.59
0.59 - 1.63
0.69-1.37
0.75 -1.45
0.12
0.13
0.40
0.046
0.14
0.83
0.75
0.95
0.88
0.80
1.09
1.07
0.91
0.64
2.01
1.09
1.11
0.95
1.64
2.36
1.61
1.71
1.51
2.42
0.45 -2.68
0.62 -1.86
0.49 -1.68
0.31 -1.32
1.07 - 3.78
0.69 - 1.71
0.73 - 1.69
0.87-1.03
1.12 - 2.39
1.62 - 3.43
0.95 - 2.73
0.87 - 3.35
1.06 - 2.15
1.64 - 3.56
0.84
0.80
0.76
0.22
0.030
0.71
0.62
0.19
0.010
<0.001
0.079
0.12
0.023
<0.001
AAD=antiarrhythmic drug, ACE=angiotensin converting enzyme, ARB=angiotensin
receptor blocker, CABG=coronary artery bypass graft surgery, CM=cardiomyopathy,
CRT-D=cardiac resynchronization defibrillator, eGFR=estimated glomerular filtration
rate, ICD=implantable cardioverter defibrillator, LA=left atrium, LVEDD=left ventricular
end-diastolic dimension, LVEF=left ventricular ejection fraction, LVESD=left ventricular
end-systolic dimension, NYHA=New York Heart Association, PCI=percutaneous
coronary intervention; To convert serum creatinine to SI units (mol/L), multiply by 88.4