Outcomes of elderly recipients of implantable cardioverter defibrillators.
OBJECTIVE
To examine the patterns of use, complication rates, and survival in elderly recipients of implantable cardioverter defibrillators (ICD).


RESULTS
We followed 500 consecutive patients included in the Marburg Defibrillator database for 48+/-39 months. There were 40 patients (8%) >/= 75 and 460 (92%) < 75 years of age at the time of implant. The 5-year Kaplan-Meier estimate for appropriate treatment of VT or VF by ICD was 49% among patients < 75- versus 57% among patients >/= 75-years-old (P = 0.17). The 5-year sudden death rate was similarly low in both groups of patients (2% versus 3%). The 5-year overall mortality rate was significantly higher in patients >/= 75 than in patients < 75 years of age (55% versus 21%, P = 0.001), due to a higher mortality from heart failure (HF). All procedure-related, lead-related, and pulse generator-related complications were similar in both patient groups (23% versus 25%).


CONCLUSIONS
ICD therapy was equally effective in patients >/= 75 and patients < 75 years of age in the prevention of sudden cardiac death. While the complication rates were similar in both age groups, the long-term mortality was considerably higher in elderly patients, due to a higher mortality from HF. The current ICD therapy guidelines appear applicable to elderly patients who are otherwise medically stable and without advanced HF.
Grimm
Wolfram
W
Department of Cardiology, Hospital of the Philipps-University of Marburg, Philipps-University of Marburg, Germany. grimmw@med.uni-marburg.de
Stula
Astrid
A
Sharkova
Julia
J
Alter
Peter
P
Maisch
Bernhard
B
D000328:Adult; D000367:Age Factors; D000368:Aged; D017147:Defibrillators, Implantable / Q000009:adverse effects* / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D017180:Tachycardia, Ventricular / Q000401:mortality / Q000628:therapy*; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000401:mortality / Q000628:therapy*