Automatic implantable cardioverter defibrillator: when not to implant

  • Maria Teresa La Rovere | mariateresa.larovere@icsmaugeri.it Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Montescano (PV), Italy.
  • Egidio Traversi Department of Cardiology, Istituti Clinici Scientifici Maugeri IRCCS, Institute of Montescano (PV), Italy.

Abstract

The implantable cardioverter-defibrillator (ICD) is the mainstay therapy for primary prevention of sudden cardiac death in patients with heart failure with a reduced ejection fraction. Current indications for prophylactic ICD are based on the results of randomized controlled trials dating back to 15-20 years ago, which have usually enrolled highly selected patients with few comorbidities and only a small number of patients aged >75 years. Existing literature suggest an age-dependent attenuation of the efficacy of the ICD. Because of the ageing of the population, there is need for data addressing device efficacy among older patients that also considers the impact of geriatric syndromes on health status. The assessment of frailty may be of value in identifying elderly patients who may or may not benefit from ICD placement for primary prevention of sudden cardiac death.

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Published
2020-02-21
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Issue
Section
Cardiology - Reviews
Keywords:
Implantable cardioverter defibrillator, older adults, primary prevention, frailty
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  • PDF: 188
How to Cite
La Rovere, M. T., & Traversi, E. (2020). Automatic implantable cardioverter defibrillator: when not to implant. Monaldi Archives for Chest Disease, 90(1). https://doi.org/10.4081/monaldi.2020.1225