Survival After Implantable Cardioverter-Defibrillator Implantation in the Elderly
Key result
Older age in ICD recipients was associated with increased mortality (Ptrend<0.001) but no significant decline in appropriate shocks after primary (P=0.130) or secondary (P=0.810) prevention.
Why the study?
Does older age impact mortality and the rate of appropriate device shocks in patients receiving primary or secondary prevention ICDs?
Population
5,399 primary or secondary prevention implantable cardioverter-defibrillator recipients in Ontario, Canada
Comparison
Implantable cardioverter-defibrillator… vs Comparison across age groups
Design
Cohort
Authors
Discussion
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Implication
Higher mortality with similar shock rates in older ICD recipients is hypothesis-generating; prospective trials needed to assess net benefit.
Study Design
Type
Cohort (n=5,399)
Multicenter
Yes
Structured PICO
Does older age impact mortality and the rate of appropriate device shocks in patients receiving primary or secondary prevention ICDs?
P
Population
5,399 primary and secondary prevention ICD recipients aged 18 and older in a prospective registry in Ontario, Canada.
E
Exposure
Implantable cardioverter-defibrillator (ICD) implantation
C
Comparator
Comparison across age groups (18-49, 50-59, 60-69, 70-79, and ≥80 years)
O
Outcome
Mortality and device-delivered therapies (appropriate shocks)hard clinical
Main Result
p-value: p=<0.001
Elderly patients experience higher mortality after ICD implantation but have similar rates of appropriate device shocks compared to younger patients, suggesting age alone should not preclude ICD candidacy.
Cite This Study
Yung et al. (2013) conducted a cohort in Implantable cardioverter-defibrillator (ICD) recipients (n=5,399). Older age vs. Younger age was evaluated on Mortality and appropriate device shocks (p=<0.001). Older age in ICD recipients was associated with increased mortality (Ptrend<0.001) but no significant decline in appropriate shocks after primary (P=0.130) or secondary (P=0.810) prevention.