首页 | 本学科首页   官方微博 | 高级检索  
检索        


Safety and effectiveness of primary prevention cardioverter defibrillators in octogenarians
Authors:Strimel William  Koplik Sheri  Chen H Robert  Song Juhee  Huang Shoei K Stephen
Institution:Section of Cardiac Electrophysiology and Pacing, Division of Cardiology, Texas A&M University Health Science Center, College of Medicine, Temple, Texas, USA.
Abstract: Background: Implantable cardioverter‐defibrillators (ICDs) reduce the rate of sudden cardiac death (SCD) in patients with cardiomyopathy and reduced left ventricular systolic function. It is unclear if this benefit extends to the very elderly patient population. Methods: Patients who underwent initial ICD implantation at age 80 or older between January 1995 and April 2010 for primary SCD prevention were identified. Clinical data were collected from the medical record, including periprocedural complications, device type, and therapies delivered. Results: Three‐hundred eighty patients were identified; 84 patients met eligibility criteria. The mean age was 82.68 years; mean follow‐up was 34 months. Mean left ventricular ejection fraction was 28.1%. Mortality during follow‐up was 17.9%. One‐ and 5‐year survival estimates were 100% and 60%, respectively. Periprocedural complications occurred in 9.4% of patients; serious complications occurred in 4.8% with no periprocedural deaths. Device therapies occurred in 11.9% (n = 10) of patients (9.5% appropriate, n = 8; 2.4% inappropriate, n = 2). Cardiac resynchronization therapy‐defibrillator (CRT‐D) implantation was associated with prolonged median survival and decreased risk of death (hazard ratio 0.212; 95% confidence interval 0.048?.942, P = 0.042) compared to ICD alone. Conclusions: Implantation of primary prevention ICDs in patients 80 years of age or older was associated with a low risk of serious complications and a 5‐year survival estimate of 60%. Inappropriate therapies after implantation were uncommon. CRT‐D implantation was associated with a decreased risk of death compared to ICD alone. These data suggest that, in selected patients in this age group, ICD implantation is safe and effective. (PACE 2011; 34:900–906)
Keywords:cardioverter‐defibrillator  sudden cardiac death  octogenarian
本文献已被 PubMed 等数据库收录!
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号