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

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Cardiac resynchronization therapy in the ageing population - With or without an implantable defibrillator?

Michael Döring1, Micaela Ebert2, Nikolaos Dagres1

  • 1Department of Electrophysiology, Heart Center, University of Leipzig, Leipzig, Germany.

International Journal of Cardiology
|May 15, 2018
PubMed

Insights

Adding an implantable cardioverter-defibrillator (ICD) to cardiac resynchronization therapy (CRT) did not improve survival in elderly patients. Further randomized trials are needed to confirm these findings on CRT-D versus CRT-P in older populations.

Area of Science:

  • Cardiology
  • Medical Devices
  • Geriatric Medicine

Background:

  • Cardiac resynchronization therapy (CRT) is established for systolic heart failure.
  • The role of an additional implantable cardioverter-defibrillator (ICD) in elderly CRT recipients is unclear.
  • This study addresses the survival impact of ICDs in older CRT patients.

Purpose of the Study:

  • To evaluate the effect of an additional ICD on survival in elderly patients receiving CRT.
  • To compare outcomes between CRT with a pacemaker (CRT-P) and CRT with a defibrillator (CRT-D) in patients aged 75 years and older.

Main Methods:

  • Retrospective analysis of 177 elderly patients (≥75 years) undergoing CRT implantation.
  • Patients were divided into CRT-P (n=80) and CRT-D (n=97) groups.
  • All-cause mortality was analyzed during a mean follow-up of 26 months.

Main Results:

  • No significant difference in all-cause mortality between CRT-P and CRT-D groups (35% in both).
  • Kaplan-Meier survival analysis showed no significant difference between the groups (p=0.562).
  • CRT-P patients were older and more often female, with better LVEF and narrower QRS compared to CRT-D.

Conclusions:

  • An additional ICD did not impact survival in elderly patients receiving CRT.
  • The findings suggest no survival benefit of CRT-D over CRT-P in this specific elderly cohort.
  • Further randomized controlled trials are necessary to validate these results.
Abstract

Keywords:
All-cause mortalityCardiac resynchronization therapyHeart failureImplantable cardioverter defibrillatorSudden cardiac death

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