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Current Geriatrics Reports
Published in: Current Geriatrics Reports 4/2017

01-12-2017 | Cardiovascular Disease in the Elderly (M Chen, Section Editor)

Implantable Cardioverter-Defibrillator Implantation, Continuation, and Deactivation in Elderly Patients

Authors: J. William Schleifer, Win-Kuang Shen

Published in: Current Geriatrics Reports | Issue 4/2017

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Abstract

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.
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Metadata
Title
Implantable Cardioverter-Defibrillator Implantation, Continuation, and Deactivation in Elderly Patients
Authors
J. William Schleifer
Win-Kuang Shen
Publication date
01-12-2017
Publisher
Springer US
Published in
Current Geriatrics Reports / Issue 4/2017
Electronic ISSN: 2196-7865
DOI
https://doi.org/10.1007/s13670-017-0226-9

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