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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
16:40

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation

Published on: February 28, 2012

Improved survival associated with prophylactic implantable defibrillators in elderly patients with prior myocardial

David T Huang1, Henry W Sesselberg, Scott McNitt

  • 1Cardiology Unit, the Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA. david_huang@urmc.rochester.edu

Journal of Cardiovascular Electrophysiology
|June 1, 2007
PubMed

Insights

Implantable cardioverter-defibrillators (ICDs) offer a mortality benefit in elderly patients comparable to younger patients. This defibrillator therapy showed no compromise in the quality of life for older individuals.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Medical Devices

Background:

  • Primary prevention of sudden cardiac death (SCD) with implantable cardioverter-defibrillators (ICDs) is established in patients with coronary disease and depressed left ventricular ejection fraction (LVEF).
  • Evaluation of ICD therapy in elderly patients (≥75 years) is crucial given their potential vulnerability.

Purpose of the Study:

  • To assess the mortality benefit of defibrillator therapy in eligible elderly patients.
  • To compare the efficacy and quality of life outcomes of ICDs in elderly versus younger patients.

Main Methods:

  • A cohort of 1,232 patients with prior myocardial infarction and LVEF ≤0.30 were analyzed.
  • 204 patients were ≥75 years old; 121 received ICD implants.
  • Clinical covariates, mortality risk (hazard ratio), and quality of life (Health Utilities Index Mark III) were compared between elderly and younger patients, and between conventional and defibrillator therapy groups.

Main Results:

  • Elderly patients (≥75 years) had higher rates of atrial fibrillation, elevated BUN, widened QRS, and lower beta-blocker/statin use.
  • The mortality hazard ratio for ICD therapy in elderly patients was 0.56 (P=0.08), compared to 0.63 (P=0.01) in younger patients.
  • Quality of life reductions were similar between conventional and ICD therapy groups in elderly patients at 1 and 2 years.

Conclusions:

  • Implantable cardioverter-defibrillators provide an equivalent mortality reduction in elderly patients compared to younger patients.
  • Defibrillator therapy does not compromise quality of life in older individuals eligible for primary prevention of sudden cardiac death.
Abstract

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