Current Cardiovascular Risk Reports

, Volume 3, Issue 5, pp 347–354

Electrophysiological device therapy (implantable defibrillators) in older adults


DOI: 10.1007/s12170-009-0051-6

Cite this article as:
Li, W. & Olshansky, B. Curr Cardio Risk Rep (2009) 3: 347. doi:10.1007/s12170-009-0051-6


Controlled clinical trials provide incontrovertible evidence that implantable cardioverter defibrillators (ICDs) are effective to reduce risk of death in select patients with ischemia or nonischemic cardiomyopathy and/or malignant ventricular arrhythmias. Although indications for ICDs have expanded, few data are available regarding their use in the elderly and extreme elderly patients. As increasing numbers of patients become eligible for ICD implantation, questions arise regarding the benefit of ICDs in the elderly, in whom risk of death from comorbidities and nonarrhythmic cardiovascular causes is higher. Although guidelines support ICD implantation in appropriately selected elderly patients, the proper selection of patients remains controversial. Those elderly patients with multiple comorbidities and limited life expectancy may not be appropriate candidates for ICD implantation, even if they meet standard guidelines. Decisions must be individualized and based on clinical judgment, careful understanding of the risks and benefits of an ICD, and preferences of the patient and the family.

Copyright information

© Current Medicine Group, LLC 2009

Authors and Affiliations

  1. 1.University of Iowa HospitalsIowa CityUSA

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