More heart implants may not be better for the elderly

While implantable cardioverter-defibrillators (ICDs) can prevent sudden cardiac death and reduce overall mortality in younger patients, they may not be as effective for older patients.

ICDs — which are implanted in the chest like a pacemaker — work by monitoring heartbeats and delivering electrical shocks to reestablish normal rhythms if needed.

Research published in the Annals of Internal Medicine on November 1 found that ICD therapy in patients with severe left ventricular dysfunction over the age of 75 does not have significant effects.

Results of the study found that preventive ICD therapy did not result in a significant reduction in mortality for elderly patients.

Other studies have revealed that elderly patients with this heart condition already have a reduced life expectancy – and the use of ICDs does not lower this risk. Because the elderly are also underrepresented in primary ICD trials, the evidence that they benefit as much from ICD therapy as younger patients is already questionable, according to the Italian researchers who conducted this study.

The researchers concluded by calling for a “properly designed randomized trial” of ICDs in older patients. They also suggested that the cost-effectiveness of this therapy needs to be taken into account considering the smaller survival benefit of these patients.

— Trishula Patel

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