Secondary prevention implantable cardioverter-defibrillator (ICD) therapy in octogenarians: effective and safe
Abstract Aims Implantable cardioverter-defibrillator is well established for secondary prevention, but there is a lack of studies showing efficacy and safety in the elderly. The current study compared the outcome of octogenarians after ICD implantation to other age groups. Methods Data was achieved from a local ICD registry. Patients who received ICD implantation for secondary prevention were included. All-cause mortality, appropriate ICD therapy and acute adverse events requiring surgical intervention were compared between different age groups. Results 519 patients were enrolled. 34 patients were ≥80 years. Over a median follow-up of 35 months after ICD implantation 129 patients (annual mortality rate 5.0%) died, including 16 patients in the age group ≥80 years (annual mortality rate 9.4%). Mortality rate in the age group ≥80 years was significantly higher than in the age groups ≤69 years (p<0.001) but no difference could be seen compared to age groups 70–79 y. Age at the time of ICD implantation was an independent predictor of all-cause mortality (p<0.001). 29.7% of patients had appropriate ICD therapy with no difference between age groups. Acute adverse events leading to surgical intervention were low (n=13) and not age-related. Conclusion Age is an independent predictor of mortality after ICD implantation for secondary prevention. No difference in mortality rate could be seen between octogenarians and other elderly from 70 – 79 years. Appropriate ICD therapy and acute adverse events leading to surgical intervention were not age-related. Implantable cardioverter-defibrillator for secondary prevention seems to be an effective and safe therapy in octogenarians. FUNDunding Acknowledgement Type of funding sources: None.