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Ann Thorac Surg 1997;64:1713-1717
© 1997 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Favorable Results of Implantable Cardioverter-Defibrillator Implantation in Patients Older Than 70 Years

Kara J. Quan, MD, Jai H. Lee, MD, Otto Costantini, MD, Anastasios K. Konstantakos, MD, Helen K. Murrell, BS, Mark D. Carlson, MD, Judith A. Mackall, MD, Lee A. Biblo, MD, Alexander S. Geha, MD

Divisions of Cardiothoracic Surgery and Cardiology, Case Western Reserve University School of Medicine, University Hospitals of Cleveland, Cleveland, Ohio

Accepted for publication June 9, 1997.

Background. The clinical results of implantable cardioverter-defibrillator (ICD) implantation in the elderly have received limited documentation. As the longevity of the U.S. population has increased, so has the need for ICD implantation in the elderly. We evaluated the efficacy and outcome of ICD implantation in elderly patients (>70 years) compared with younger patients.

Methods. The case records of all consecutive patients who underwent ICD implantation at our institution between 1986 and 1994 were reviewed. Of a total of 238 patients, 78 patients were 70 years of age or older and 160 patients were younger than 70 years of age.

Results. The mean age of the younger group was 58 years and that of the elderly group was 74 years. There were no statistical differences in the presence of coronary artery disease, left ventricular systolic function, the inducibility of arrhythmias, or the history of sudden cardiac death. The hospital morbidity rate was similar in both groups (6.9% in the younger group and 7.7% in the elderly group; p = not significant). The operative mortality rate was 1.9% for the younger group and 1.3% for the elderly group (p = not significant). At a mean follow-up of 33 ± 26 months, Kaplan-Meier survival curves demonstrated similar survival rates, with 93%, 82%, and 65% of the patients alive at 1, 3, and 6 years, respectively.

Conclusions. Implantable cardioverter-defibrillator implantation was equally effective in the treatment of patients older than 70 years as in younger patients. No differences in theoretic survival or morbidity were observed.






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