Effectiveness of Implantable Defibrillators in Octogenarians and Nonagenarians for Primary Prevention of Sudden Cardiac Death

Mezu, Ure; Adelstein, Evan; Jain, Sandeep; Saba, Samir

doi:10.1016/j.amjcard.2011.04.022

Cited by 30 publications

(22 citation statements)

References 14 publications

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“…A recent study showed that age and GFR are the only indipendent predictors of survival in patients ≥ 80 years old, whereas ICD do not appear to influence the overall survival [82]. Of note, in none of the ICD recipients followed in this study there were any true instances of documented ventricular fibrillation, which adds to the evidence that ICDs are unlike to influence survival in this patient population and is consistent with previous reports [83].…”

Section: Agesupporting

confidence: 91%

Implantable Cardioverter-Defibrillators in Sudden Cardiac Death Prevention: What Guidelines Don't Tell

Giaccardi¹,

Colella²,

Santoro³

et al. 2013

Cardiac Defibrillation

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Section: Agesupporting

confidence: 91%

Implantable Cardioverter-Defibrillators in Sudden Cardiac Death Prevention: What Guidelines Don't Tell

Giaccardi¹,

Colella²,

Santoro³

et al. 2013

Cardiac Defibrillation

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“…The 2013 guidelines were updated to include the following statement, “The usefulness of implantation of an ICD is of uncertain benefit to prolong meaningful survival in patients with a high risk of non-sudden death as predicted by frequent hospitalizations, advanced frailty, or comorbidities such as systemic malignancy or severe renal dysfunction” (Class IIb). In the National Cardiovascular Data Registry for primary prevention ICDs, half of patients are NYHA III/IV 9 and a third are ≥75 years old, patients in whom a primary prevention ICD may have a diminished benefit 7 .…”

Section: Introductionmentioning

confidence: 99%

Does the Implantable Cardioverter-Defibrillator Benefit Vary With the Estimated Proportional Risk of Sudden Death in Heart Failure Patients?

Levy

Reed

et al. 2017

JACC: Clinical Electrophysiology

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Background Prediction of which heart failure patients are most likely to die of sudden death vs. non-sudden death is an important factor in determining who will benefit the most from an ICD. Objective We developed the Seattle Proportional Risk Model (SPRM) to estimate the proportion of total mortality due to sudden death. We prospectively validated the model in HF-ACTION and tested whether the ICD benefit varied with the SPRM. Methods Among 2331 patients enrolled, 1947 patients were retained for analysis over a median follow-up of 2.5 years. The SPRM was calculated using age, gender, diabetes, BMI, SBP, EF, NYHA, sodium, creatinine, and digoxin use. Results ICD use (ICD or CRT-D) was present prior to death in 1204 patients (62%). SPRM was predictive of sudden death vs. non-sudden death in those without an ICD (P=0.002). The hazard ratio representing ICD versus no ICD was 0.63 for all-cause mortality (P=0.0002). The ICD benefit varied with the SPRM for all-cause mortality (P=0.001), with a greater benefit in those with a higher conditional probability of sudden death. Conclusions In an ambulatory NYHA II-IV HF population and EF ≤35%, the SPRM was predictive of the proportional risk of sudden vs. non-sudden death. ICDs were associated with a decreased risk of all-cause mortality by 37% and the ICD benefit varied with the SPRM. The SPRM may have utility in risk stratifying patients for a primary prevention ICD.

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“…The role of inducibility of VA in electrophysiological study for risk stratification of asymptomatic Brugada syndrome has been a source of great debate (8,22). A large observational study (10) had shown an extremely high incidence of spontaneous ventricular fibrillation (28%) in patients with inducible VA on electrophysiological study, as opposed to only 2% in patients with noninducible VA.…”

Section: Discussion: Partmentioning

confidence: 99%

Systematic Review for the 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

Kusumoto¹,

Bailey²,

Chaouki³

et al. 2018

Circulation

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These members of the evidence review committee are listed alphabetically, and all participated equally in the process. †Former Task Force member; current member during the writing effort. Copies: This document is available on the World Wide Web sites of the American College of Cardiology (www.acc.org), the American Heart Association (professional.heart.org), and the Heart Rhythm Society (www.hrsonline.org). A copy of the document is available at http://professional.heart.org/statements by using either "Search for Guidelines & Statements" or the "Browse by Topic" area. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@wolterskluwer.com.Expert peer review of AHA Scientific Statements is conducted by the AHA Office of Science Operations. For more on AHA statements and guidelines development, visit http://professional.heart.org/statements. Select the "Guidelines & Statements" drop-down menu, then click "Publication Development."Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American Heart Association. Instructions for obtaining permission are located at http://www.heart.org/HEARTORG/General/Copyright-Permission-Guidelines_UCM_300404_Article.jsp. A link to the "Copyright Permissions Request Form" appears on the right side of the page. 1........................................................................................................................ 1............................................................................................................................. 1 .................................................................................................................................... 8 Discussion: Part 1 ............................................................................................................................... 8 Limitations: Part 1............................................................................................................................... 9 Figures and Table......................................................................................................................... ................................................................................................................... 2........................................................................................................................... ..........................................................................................................................

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Effectiveness of Implantable Defibrillators in Octogenarians and Nonagenarians for Primary Prevention of Sudden Cardiac Death

Cited by 30 publications

References 14 publications

Implantable Cardioverter-Defibrillators in Sudden Cardiac Death Prevention: What Guidelines Don't Tell

Implantable Cardioverter-Defibrillators in Sudden Cardiac Death Prevention: What Guidelines Don't Tell

Does the Implantable Cardioverter-Defibrillator Benefit Vary With the Estimated Proportional Risk of Sudden Death in Heart Failure Patients?

Systematic Review for the 2017 AHA/ACC/HRS Guideline for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death

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