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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

Implantable cardioverter-defibrillator prescription in the elderly

Andrew E Epstein1, G Neal Kay, Vance J Plumb

  • 1University of Alabama at Birmingham, Birmingham, Alabama 35294, USA. aepstein@uab.edu

Heart Rhythm
|June 23, 2009
PubMed

Insights

Over 40% of new implantable cardioverter-defibrillators (ICDs) are implanted in patients over 70, with many older recipients not meeting CRT-D criteria. Cardiac death rates were similar, but noncardiac mortality increased with age.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Medical Devices

Background:

  • Sudden cardiac death risk rises with age, suggesting elderly benefit from implantable cardioverter-defibrillators (ICDs).
  • Elderly patients are underrepresented in clinical trials, potentially limiting understanding of ICD benefits in this demographic.
  • Comorbid conditions in older adults may influence the effectiveness of ICDs.

Purpose of the Study:

  • To investigate the prescription patterns of ICDs in elderly patient populations.
  • To compare ICD implantation trends between the Advancements in ICD Therapy (ACT) Registry and the National Cardiovascular Data Registry (NCDR).

Main Methods:

  • Comparison of patient demographics, implantation indications, and device types between the ACT Registry and NCDR datasets.
  • Analysis of age distribution, primary prevention rates, and single-chamber ICD use across different age groups.
  • Evaluation of two-year mortality rates and causes of death in relation to patient age and ICD implantation.

Main Results:

  • Over 40% of new ICDs and cardiac resynchronization therapy defibrillators (CRT-Ds) were implanted in patients older than 70 years.
  • A significant proportion of elderly patients, particularly those aged 80 and above, received devices for primary prevention.
  • While noncardiac death was more frequent in older patients, cardiac death rates remained similar across age groups.

Conclusions:

  • The study highlights a substantial implantation rate of ICDs and CRT-Ds in elderly individuals (>70 years).
  • A notable percentage of older patients receiving CRT-Ds did not meet established implantation criteria.
  • Noncardiac mortality is a more significant concern in older ICD recipients, whereas cardiac mortality shows no significant age-related difference.
Abstract

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