Health, Not Age, Affects Benefits of Implanted Heart Device: Study
Issue is important to growing number of elderly living with heart disease, researcher says
Monday, June 17, 2013
An implantable cardioverter defibrillator, or ICD, is a device placed inside the chest to deliver electrical shocks to restore normal heartbeat if it detects a dangerous abnormal heart rhythm.
The findings indicate that overall health, not just a person's age, should be used to predict whether a patient will benefit from receiving this type of device and help determine who should receive one, according to the authors of the study, which was published June 17 in the journal Circulation.
"Whether elderly patients benefit from the devices has been controversial and research on the topic is lacking," lead author Dr. Douglas Lee, a scientist at the Institute for Clinical Evaluative Sciences and a cardiologist at the Peter Munk Cardiac Centre in Toronto, said in a journal news release. "The issue is important as the population ages and the number of elderly people living with heart disease grows."
Lee's team looked at nearly 5,400 patients who had the devices implanted. The patients had poor heart function due to heart failure or a prior heart attack, or after being resuscitated from cardiac arrest.
Among those who received the implanted device with heart failure or after heart attack, 38 percent were aged 70 or older and 7 percent were 80 or older. Among those who received the device after surviving a cardiac arrest, 42 percent were 70 or older and nearly 11 percent were in their 80s.
"Older patients were just as likely to experience an appropriate electrical shock from the device to treat a life-threatening heart rhythm," said Lee, who is also associate professor of medicine at the University of Toronto. "However, older patients experienced more noncardiac and cardiovascular hospitalizations and higher associated rates of death overall."
For example, among patients receiving an ICD to prevent cardiac arrest, the death rate among patients aged 18 to 49 was two per 100 patients, compared with 10 per 100 patients among those 80 and older.