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Implanted Cardiac Devices Effective in Healthy Elderly, Too

Rates of appropriate shocks from ICDs similar regardless of age
WEDNESDAY, June 19 (HealthDay News) -- Although total mortality is higher among elderly patients, rates of appropriate shocks from implantable cardioverter-defibrillators (ICDs) are similar across age groups, according to research published in the June 18 issue of Circulation.
Derek Yung, M.D., of the Institute for Clinical Evaluative Sciences in Toronto, and colleagues examined the effect of age on device-delivered treatments and outcomes in primary or secondary prevention ICD recipients. Device-delivered therapies and complications assessed at routine clinic visits from February 2007 to September 2010 were recorded in a prospective, inclusive registry of 5,399 ICD recipients in Ontario, Canada.
The researchers found that mortality increased significantly with age for patients aged 18 to 49 years (317 recipients; 2.1 deaths per 100 person-years), 50 to 59 years (769; 3.0), 60 to 69 years (1,336; 5.4), 70 to 79 years (1,242; 6.9), and 80 years or older (275; 10.2) who received primary preventive therapy with an ICD. A similar pattern of significantly increasing mortality with age was observed among patients aged 18 to 49 years (114 recipients; 2.2 deaths per 100 person-years), 50 to 59 years (244; 3.8), 60 to 69 years (481; 6.1), 70 to 79 years (462; 8.7), and 80 years or older (159; 15.5) who received secondary preventive therapy with an ICD. For those receiving primary and secondary preventive therapy with an ICD, no significant difference was observed in rates of appropriate shocks (in number of shocks per 100 person-years of follow-up) for the youngest age group (18 to 49 years; 6.7 and 11.4, respectively) compared with the oldest age group (80 years or older; 4.2 and 11.9, respectively).
"Decisions regarding ICD candidacy should not be based on age alone but should consider factors that predispose to mortality despite defibrillator implantation," the authors write.
Several study authors disclosed financial ties to pharmaceutical and medical device companies.
Abstract (http://circ.ahajournals.org/content/127/24/2383.abstract )Full Text (http://circ.ahajournals.org/content/127/24/2383.full )
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