Implantable Defibrillators Can Be Beneficial at Any Age

Heart patients over the age of 70 have often been excluded from clinical trials, sometimes based only on their age, but a U.S. study released last week has established that patients over the age of 70 can benefit from some of the same treatments as younger patients.

Implanted Cardioverter Defibrillators, or ICDs, are small devices implanted under the skin with wires leading to the heart. The devices are powered by batteries that can last between three and six years and will recognize irregular heart beats and shock a slow beating heart into a faster rhythm or stabilize a heart that is beating irregularly. They save lives in younger patients and, as shown by the recent study, they appear to have the same benefits for patients over 70. The indication is that the devices should be offered to older patients despite some research which questions their use in this group of the population.

The lead author of the study, Dr. Paul Chan of the University of Missouri in Kansas City, said, There does not appear to be a difference in benefit between younger and older patients. We need to ensure we avoid undertreatment of older patients."

This study involved 986 patients with heart damage and ran from March 2001 to June 2005. The average age of the study group was 67 -- three to seven years older than two other clinical trials of the devices. The entire group had low heart-pumping function and there were also other conditions such as diabetes present in many of the group. Around half of the group was given ICDs.

The rate of deatii from all causes was 30 percent less with the devices and was similar to studies involving younger patients.Chan said the benefit was less for those over 75 with other significant health problems.

ICDs are most commonly implanted in patients who have survived an episode of ventricular tachycardia or fibrillation, or whose patient history indicates a likelihood of developing sustained tachycardia or fibrillation. ICDs have shown to be superior to drugs in prolonging the life of these patients, but the decisions in the use of ICDs should be based on the individual and older patients should not be routinely excluded.