Role of the implantable defibrillator among elderly patients with a history of life-threatening ventricular arrhythmias
Why the study?
Does an implantable defibrillator reduce all-cause mortality and arrhythmic death compared to amiodarone in elderly patients with a history of life-threatening ventricular arrhythmias?
Population
1,866 patients with a history of life-threatening ventricular arrhythmias pooled from 3 secondary prevention…
Comparison
Implantable defibrillator (ICD) vs Amiodarone
Design
Meta-analysis
Follow-up
mean 2.3 years
Authors
Discussion
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Member takes
Implication
No mortality benefit with ICDs in patients ≥75 years; challenges broad use and leaves open optimal therapy in elderly ventricular arrhythmia patients.
Structured PICO
Does an implantable defibrillator reduce all-cause mortality and arrhythmic death compared to amiodarone in elderly patients with a history of life-threatening ventricular arrhythmias?
P
Population
1,866 patients with a history of life-threatening ventricular arrhythmias pooled from 3 secondary prevention trials, mean age 63.7 years.
I
Intervention
Implantable defibrillator (ICD)
C
Comparator
Amiodarone
O
Outcome
All-cause mortality and arrhythmic deathhard clinical
In elderly patients (>= 75 years) with life-threatening ventricular arrhythmias, ICD therapy may not provide the same survival benefit over amiodarone as seen in younger patients, likely due to a higher competing risk of non-arrhythmic death.
Cite This Study
Healey et al. (2007) studied this question.