EXPERIENCE WITH IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR THERAPY IN ELDERLY PATIENTS

Aim Concern exists about the benefit of implantable defibrillator ther apy in elderly patients. We assessed the utility of implantable defibr illator therapy and its effect on mortality in patients 70 years and o lder and compared results in this group to those in younger patients. Methods and results Thirty-two out of 200 consecutive patients (16%) w ere 70 years or older at the time of implantation of a defibrillator. When comparing elderly to younger patients no significant differences were noted with respect to presenting arrhythmia, left ventricular eje ction fraction or presence of an old myocardial infarction. Elderly pa tients had st higher prevalence of ischaemic heart disease, while in t he younger group more patients had idiopathic ventricular tachycardia. Cumulative survival curves (Kaplan-Meier method) for all-cause mortal ity, sudden cardiac death and non-sudden cardiac death were constructe d for elderly and younger patients. No significant differences for cum ulative survival from all-cause mortality (75 vs 74%), sudden cardiac death (0 vs 4%) and non-sudden cardiac death (97 vs 93%) were found. T he incidence of appropriate shocks during follow-up was comparable (65 vs 72%). Conclusion Implantable defibrillator therapy was effective i n preventing sudden cardiac death in the elderly. Total mortality was similar to younger patients at a follow-up of 19 +/- 14 and 25 +/- 19 months, respectively Age itself should be no contraindication to impla ntable cardioverter defibrillator therapy.