Abstract
Do elderly patients benefit from implantable-cardioverter defibrillators?
Highlights
Sudden cardiac death resulting from lethal ventricular arrhythmias forms a major cause of mortality
It was recently reported that there were fewer cases of ventricular fibrillation encountered during out-of-hospital cardiac arrest between 2005–2008, compared with the time frame 1995–1997, which could be explained in part (33 %) by the increased number of implantable cardioverter defibrillator (ICD) carriers among subjects vulnerable for sudden death.[2]. ICDs only protect against ventricular arrhythmia-induced cardiac arrest, and the question arises whether some ICD candidates may not have too many life-threatening comorbid conditions to have the chance to experience gain in life expectancy from ICD implantation
Goldenberg et al performed a post hoc analysis of the MADIT 2 trial, and proposed a simple and applicable clinical model of five risk factors associated with the usefulness of ICD therapy.[3;4] They showed that a risk score model including: 1) age above 70 years, 2) renal insufficiency, 3) atrial fibrillation, 4) NYHA class >2 and 5) a QRS complex
Summary
Sudden cardiac death resulting from lethal ventricular arrhythmias forms a major cause of mortality.
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