Device therapy in patients with heart failure and advanced age: Too much too late?

Raymond Cutro, Michael W. Rich, Paul Hauptman

Research output: Contribution to journalReview article

12 Citations (Scopus)

Abstract

Expanding indications for implantable cardiac rhythmdevices coupledwith the aging of the population have led to a progressive rise in the number of elderly patients referred for device implantation. However, the value of implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy (CRT) in elderly patients remains unproven, in part because few patients over 75 years of age were enrolled in the major device trials. In this article, we summarize the current evidence base regarding the use of device therapy in elderly heart failure patients.We review the efficacy, complications, indications, cost, and current controversies surrounding the use of ICDs and CRT in the geriatric age group. We conclude that reduced benefit coupled with higher complication rates and associated higher costs make it unlikely that the net clinical benefit of an ICD is favorable in most patients over 75 to 80 years of age. Conversely, preliminary data indicate that elderly patients undergoing CRT experience improved quality of life at acceptable cost, suggesting that CRTmay be an attractive therapeutic option in appropriately selected patients of advanced age.

Original languageEnglish (US)
Pages (from-to)52-55
Number of pages4
JournalInternational Journal of Cardiology
Volume155
Issue number1
DOIs
StatePublished - Feb 23 2012
Externally publishedYes

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Heart Failure
Equipment and Supplies
Cardiac Resynchronization Therapy
Implantable Defibrillators
Costs and Cost Analysis
Therapeutics
Geriatrics
Age Groups
Quality of Life
Population

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Device therapy in patients with heart failure and advanced age : Too much too late? / Cutro, Raymond; Rich, Michael W.; Hauptman, Paul.

In: International Journal of Cardiology, Vol. 155, No. 1, 23.02.2012, p. 52-55.

Research output: Contribution to journalReview article

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