Older age associated with risk of complications, death after implantation of cardiac devices

April 12, 2010, JAMA and Archives Journals

Older patients may be more likely to die in the hospital following the implantation of defibrillators or pacemakers, according to a report in the April 12 issue of Archives of Internal Medicine. More than one-fifth of cardiac devices appear to be implanted in individuals age 80 and older, despite the fact that most clinical trials have not included adults in this age group.

"Implantable cardiac devices have been increasingly used in primary prevention of among patients with systolic , largely on the basis of favorable results from large multicenter clinical trials," the authors write as background information in the article. One such device is an implantable cardioverter defibrillator, which monitors the heart's rhythm and delivers electrical shocks if needed to restore normal heart function. Defibrillators or pacemakers are often used to coordinate the actions of the heart's in a procedure known as cardiac resynchronization therapy.

"However, it has become increasingly apparent that certain patient subgroups may not benefit from device implantation; for example, use of implantable cardiac defibrillators in patients with and in those with advanced heart failure symptoms has not been associated with a survival benefit," the authors write. Because the average age in major clinical trials has ranged from 58 to 67 years and some have specified an upper age limit of 80 years, limited data are available on the use of these devices in .

Jason P. Swindle, M.P.H., then of Saint Louis University School of Medicine, and colleagues analyzed data from 26,887 adults who were hospitalized with a diagnosis of heart failure and underwent implantation of a defibrillator or in 2004 or 2005.

The median (midpoint) age of all patients was 70 years. Patients age 80 and older accounted for 17.5 percent of the procedures (4,694 patients), including 992 patients (21.1 percent) who were older than 85 years and 309 patients (6.6 percent) who were 89 years or older. In-hospital death rates increased from 0.7 percent among patients younger than 80 years to 1.2 percent among those age 80 to 85 and 2.2 percent among those older than 85 years.

"We found that older patients were less likely to have a concomitant cardiac procedure or a high comorbidity score, suggesting that these patients may be, in fact, somewhat more carefully selected than the younger cohort," the authors write. "However, older patients had slightly more complications related to the device procedure."

"Given trends in the demographics of heart failure and the costs of device therapy, additional studies are required to clarify the appropriateness of device implantation in older patients with heart failure, as well as the merits of less invasive options," they conclude.

More information: Arch Intern Med. 2010;170[7]:631-637.

Related Stories

Recommended for you

Spare parts from small parts: Novel scaffolds to grow muscle

February 20, 2018
Australian biomedical engineers have successfully produced a 3D material that mimics nature to transform cells into muscle.

Clues to obesity's roots found in brain's quality control process

February 20, 2018
Deep in the middle of our heads lies a tiny nub of nerve cells that play a key role in how hungry we feel, how much we eat, and how much weight we gain.

Study looks at how newly discovered gene helps grow blood vessels

February 19, 2018
A new study published today found that a newly discovered gene helps grow blood vessels when it senses inadequate blood flow to tissues.

Scientists produce human intestinal lining that re-creates living tissue inside organ-chip

February 16, 2018
Investigators have demonstrated how cells of a human intestinal lining created outside an individual's body mirror living tissue when placed inside microengineered Intestine-Chips, opening the door to personalized testing ...

Data wave hits health care

February 16, 2018
Technology used by Facebook, Google and Amazon to turn spoken language into text, recognize faces and target advertising could help doctors fight one of the deadliest infections in American hospitals.

Researcher explains how statistics, neuroscience improve anesthesiology

February 16, 2018
It's intuitive that anesthesia operates in the brain, but the standard protocol among anesthesiologists when monitoring and dosing patients during surgery is to rely on indirect signs of arousal like movement, and changes ...

1 comment

Adjust slider to filter visible comments by rank

Display comments: newest first

xzor
not rated yet Apr 13, 2010
Groundbreaking study!
This just in: Older people are more likely to die!!!

....seriously, who researches this stuff?

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.