Elderly people may gain as much benefit from having implantable cardioverter
defibrillators as younger people, according to a new study. An implantable cardioverter defibrillator, or ICD, is a device placed inside
the chest to deliver electrical shocks to restore normal heartbeat if it detects
a dangerous abnormal heart rhythm.
The findings indicate that overall health, not just a person's age, should be
used to predict whether a patient will benefit from receiving this type of
device and help determine who should receive one, according to the authors of
the study, which was published June 17 in the journal Circulation.
"Whether elderly patients benefit from the devices has been controversial and
research on the topic is lacking," lead author Dr Douglas Lee, a scientist at
the Institute for Clinical Evaluative Sciences and a cardiologist at the Peter
Munk Cardiac Centre in Toronto, said in a journal news release. "The issue is
important as the population ages and the number of elderly people living with
heart disease grows."
How the study was done
Lee's team looked at nearly 5 400 patients who had the devices implanted. The
patients had poor heart function due to heart failure or a prior heart attack,
or after being resuscitated from cardiac arrest.
Among those who received the implanted device with heart failure or after
heart attack, 38% were aged 70 or older and 7% were 80 or older. Among those who
received the device after surviving a cardiac arrest, 42% were 70 or older and
nearly 11% were in their 80s.
"Older patients were just as likely to experience an appropriate electrical
shock from the device to treat a life-threatening heart rhythm," said Lee, who
is also associate professor of medicine at the University of Toronto. "However,
older patients experienced more non-cardiac and cardiovascular hospitalizations
and higher associated rates of death overall."
For example, among patients receiving an ICD to prevent cardiac arrest, the
death rate among patients aged 18 to 49 was two per 100 patients, compared with
10 per 100 patients among those 80 and older.
The US National Heart, Lung, and Blood Institute has more about implantable