FAVORABLE RESULTS OF IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR IMPLANTATION IN PATIENTS OLDER THAN 70 YEARS

Background. The clinical results of implantable cardioverter-defibrill ator (ICD) implantation in the elderly have received limited documenta tion. As the longevity of the U.S. population has increased, so has th e need for ICD implantation in the elderly. We evaluated the efficacy and outcome of ICD implantation in elderly patients (>70 years) compar ed with younger patients. Methods. The case records of all consecutive patients who underwent ICD implantation at our institution between 19 86 and 1994 were reviewed. Of a total of 238 patients, 78 patients wer e 70 years of age or older and 160 patients were younger than 70 years of age. Results. The mean age of the younger group was 58 years and t hat of the elderly group was 74 years. There were no statistical diffe rences in the presence of coronary artery disease, left ventricular sy stolic function, the inducibility of arrhythmias, or the history of su dden cardiac death. The hospital morbidity rate was similar in both gr oups (6.9% in the younger group and 7.7% in the elderly group; p = not significant). The operative mortality rate was 1.9% for the younger g roup and 1.3% for the elderly group (p = not significant). At a mean f ollow-up of 33 +/- 26 months, Kaplan-Meier survival curves demonstrate d similar survival rates, with 93%, 82%, and 65% of the patients alive at 1, 3, and 6 years, respectively. Conclusions. Implantable cardiove rter-defibrillator implantation was equally effective in the treatment of patients older than 70 years as in younger patients. No difference s in theoretic survival or morbidity were observed. (C) 1997 by The So ciety of Thoracic Surgeons.