Session Time: 1:45pm-3:15pm
Location: Hall 3FG
Objective: To evaluate the influence of electrical stimulation settings and impedance on primary cell IPG longevity in a global registry.
Background: Deep Brain Stimulation (DBS) is an effective and well-established treatment for Parkinson’s disease (PD), and essential tremor (ET). DBS is powered by an implantable pulse generator (IPG) and battery life is an important factor to patients, caregivers and physicians. It is hypothesized that battery longevity is dependent on the usage, stimulation settings and total electrical energy delivered (TEED) by the IPG.
Methods: The Product Surveillance Registry (PSR) is a prospective long-term, multi-center global registry to monitor the reliability and safety of Medtronic DBS systems. The stimulation settings were analyzed for 613 Activa PC devices in 566 patients. Observations in the first 6 months in de novo patients were excluded due to the programming optimization period. TEED was estimated based on the stimulation parameters and observed impedances at the last available programming visit. Statistical analysis was completed using cox proportional hazard regression and Kaplan-Meier methods.
Results: The mean IPG longevity for initial device implants was 4.5 and 4.4 years, in PD and ET patients, respectively. Further analysis showed an inverse correlation of battery longevity to TEED (p<0.001) and IPG replacement. Patients in the IPG replacement group had higher stimulation settings and therefore, higher TEED and reduced battery life (Table 1). In both groups, monopolar stimulation mode was used more frequently (85 % in PD vs 71% in ET). Figure 1 displays average TEED over 12-month time intervals in the registry. TEED increased over time but the trend was not statistically significant (p>0.50).
Conclusions: IPG longevity is quite similar in PD and ET patients but shorter in replacement IPGs, likely due to an increased TEED demand in replacement IPGs. The increase in TEED overtime and higher TEED in replacement IPGs may reflect changes in stimulation parameters, usage patterns or local tissue impedance fluctuations. Overall the analysis demonstrated the expected performance of 3-5 year battery longevity for DBS therapy from real-world data collected across diverse settings.
To cite this abstract in AMA style:P. Konrad, G. Plotkin, S. Palfi, E. Cuny, J-P. Azulay, T. Witt, T. Theys, Y. Temel, G. Johnson, K. Bhatia, T. Weaver, M. Schiess, J. Krauss, S. Falowski. Teed and primary cell longevity: Results from product surveillance registry [abstract]. Mov Disord. 2018; 33 (suppl 2). https://www.mdsabstracts.org/abstract/teed-and-primary-cell-longevity-results-from-product-surveillance-registry/. Accessed December 1, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/teed-and-primary-cell-longevity-results-from-product-surveillance-registry/