Elderly benefit from using implantable defibrillators

(Press-News.org) The elderly may benefit from implantable cardioverter defibrillators as much as younger people, according to new research in the American Heart Association journal Circulation. An implantable cardioverter defibrillator (ICD) is a small battery-powered device placed under the skin of the chest which delivers electrical impulses to restore a normal heartbeat if it detects a dangerous abnormal rhythm. Overall health — not age alone — should determine how well patients will do after getting an ICD and help guide decisions about who should receive one, researchers said. "Whether elderly patients benefit from the devices has been controversial and research on the topic is lacking," said Douglas S. Lee, M.D., Ph.D., lead author and scientist at the Institute for Clinical Evaluative Sciences and cardiologist at the Peter Munk Cardiac Centre in Toronto, Ontario, Canada. "The issue is important as the population ages and the number of elderly people living with heart disease grows." Researchers studied 5,399 patients who had ICDs implanted because of poor heart function due to a prior heart attack or heart failure, or after being resuscitated from cardiac arrest. "Older patients were just as likely to experience an appropriate electrical shock from the device to treat a life-threatening heart rhythm. However, older patients experienced more non-cardiac and cardiovascular hospitalizations and higher associated rates of death overall," said Lee, who is also associate professor of medicine at the University of Toronto. Other study findings include: Among those who received an ICD with heart failure or after heart attack, 38.5 percent were 70 years or older and 7 percent were 80 years or older.
Among those who received an ICD after surviving a cardiac arrest, 42.5 percent were 70 years or older and 10.9 percent were in their 80s.
Older age correlated with increased risk of death after ICD implantation in both groups. For example, among those undergoing ICD implantation for prevention of cardiac arrest, 2 in every 100 patients ages 18-49 died whereas 10 in 100 died among those 80 years and older.
Use of the devices was equally effective among younger and older patients in restoring heart rhythm after a serious life-threatening rhythm disorder occurred. Across all age groups, ICDs more often delivered appropriate electrical shocks when implanted after cardiac arrest than when used to prevent the first cardiac arrest. ### Co-authors are Derek Yung, M.D.; David Birnie, M.B.Ch.B.; Paul Dorian, M.D.; Jeffrey S. Healey, M.D., M.Sc.; Christopher S. Simpson, M.D.; Eugene Crystal, M.D.; Andrew D. Krahn, M.D.; Yaariv Khaykin, M.D.; Douglas Cameron, M.D. and Zhongliang Chen, M.D. The Ontario Ministry of Health and Long-Term Care and the Canadian Institutes of Health Research funded the study. Read more on living with an ICD. For the latest heart and stroke news, follow us on Twitter: @HeartNews. For updates and new science from Circulation, follow @CircAHA. Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at http://www.heart.org/corporatefunding.