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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
Published on: February 28, 2012
Survival in octogenarians receiving implantable defibrillators.
Bruce A Koplan1, Laurence M Epstein, Christine M Albert
1Cardiac Arrhythmia Service/Division of Cardiology, Brigham and Women's Hospital, Boston, MA 02115, USA. bkoplan@partners.org
American Heart Journal
|September 26, 2006
Summary
Octogenarian implantable cardioverter-defibrillator (ICD) recipients have a median survival over 4 years. Ejection fraction and estimated glomerular filtration rate (eGFR) predict mortality in these elderly patients.
Area of Science:
- Cardiology
- Geriatric Medicine
- Medical Devices
Background:
- Octogenarians are underrepresented in implantable cardioverter-defibrillator (ICD) clinical trials.
- Survival outcomes for elderly patients receiving ICDs are not well-defined.
Purpose of the Study:
- To evaluate survival and identify mortality predictors in octogenarian patients receiving ICDs.
- To compare outcomes between octogenarian and younger adult ICD recipients.
Main Methods:
- Retrospective analysis of patients aged 80 years or older who received ICDs.
- Kaplan-Meier survival analysis and identification of mortality predictors.
- Comparison of octogenarian outcomes with a younger adult cohort (aged 60-70 years).
Main Results:
- Median survival was 4.2 years for octogenarians versus 7 years for the younger cohort.
- In octogenarians, ejection fraction (EF) ≤30% and estimated glomerular filtration rate (eGFR) <60 mL/min predicted mortality.
- Diabetes and QRS width >120 ms predicted mortality in the younger cohort but not in octogenarians.
Conclusions:
- Median survival for octogenarian ICD recipients exceeds 4 years.
- Baseline EF and eGFR are significant predictors of mortality in elderly ICD candidates.
- These clinical variables can aid in decision-making and setting survival expectations for older patients.
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