TY - JOUR
T1 - Implantable Cardioverter-Defibrillator Implantation, Continuation, and Deactivation in Elderly Patients
AU - Schleifer, J. William
AU - Shen, Win Kuang
N1 - Publisher Copyright:
© 2017, Springer Science+Business Media, LLC.
PY - 2017/12/1
Y1 - 2017/12/1
N2 - Purpose of Review: We review the major randomized trials and recent literature which address the impact of age on the decisions to implant, replace, and deactivate implantable cardioverter-defibrillators (ICDs) in elderly patients (≥75 years). Recent Findings: Current national trends indicate that increasing numbers of ICD recipients are elderly and that elderly patients receive ICDs in a much higher proportion than was represented in randomized controlled trials. Increasing age and increasing comorbidity burden reduce the potential survival benefit from ICD implantation. Multiple risk assessment models are reviewed, as are their limitations. Perspectives regarding ICD deactivation at end of life are explored. Summary: Because elderly patients are more likely to die from nonarrhythmic causes, the survival benefit that elderly patients receive from ICD implantation is reduced. Physicians should accurately represent the benefits and risks when counseling elderly patients with an indication for ICD implantation.
AB - Purpose of Review: We review the major randomized trials and recent literature which address the impact of age on the decisions to implant, replace, and deactivate implantable cardioverter-defibrillators (ICDs) in elderly patients (≥75 years). Recent Findings: Current national trends indicate that increasing numbers of ICD recipients are elderly and that elderly patients receive ICDs in a much higher proportion than was represented in randomized controlled trials. Increasing age and increasing comorbidity burden reduce the potential survival benefit from ICD implantation. Multiple risk assessment models are reviewed, as are their limitations. Perspectives regarding ICD deactivation at end of life are explored. Summary: Because elderly patients are more likely to die from nonarrhythmic causes, the survival benefit that elderly patients receive from ICD implantation is reduced. Physicians should accurately represent the benefits and risks when counseling elderly patients with an indication for ICD implantation.
KW - Cardiac resynchronization therapy
KW - Elderly
KW - Frailty
KW - Implantable cardioverter-defibrillator
KW - Palliative care
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U2 - 10.1007/s13670-017-0226-9
DO - 10.1007/s13670-017-0226-9
M3 - Review article
AN - SCOPUS:85037522196
VL - 6
SP - 279
EP - 289
JO - Current Geriatrics Reports
JF - Current Geriatrics Reports
SN - 2196-7865
IS - 4
ER -