Letters5 April 2011Age and Effectiveness of Prophylactic Implantable Cardioverter-DefibrillatorsPasquale Santangeli, MD, Luigi Di Biase, MD, PhD, and Andrea Natale, MDPasquale Santangeli, MDFrom Catholic University of the Sacred Heart, 00168 Rome, Italy; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX 78705; and Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX 78705.Search for more papers by this author, Luigi Di Biase, MD, PhDFrom Catholic University of the Sacred Heart, 00168 Rome, Italy; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX 78705; and Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX 78705.Search for more papers by this author, and Andrea Natale, MDFrom Catholic University of the Sacred Heart, 00168 Rome, Italy; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX 78705; and Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX 78705.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-154-7-201104050-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciated Drs. Barsheshet and Goldenberg's letter. We fully agree that comorbid conditions may play a significant role in determining the survival benefit of prophylactic ICD therapy (1). As such, we clearly stated in the abstract, introduction, and discussion sections of our article that the lack of adjustment for comorbid conditions may be a potential limitation of our analysis.We respectfully disagree that MADIT-II subgroup analyses sufficiently provide consistent evidence that age does not attenuate the benefit of ICD therapy (1). Drs. Barsheshet and Goldenberg state that the benefit of ICD in MADIT-II was “most prominent” among patients ...