From EP Lab Digest’s LinkedIn Group Page:

One study questions the use of implantable defibrillators and pacemakers in patients aged 80 and older. What are your thoughts?

To join in on this discussion, please visit our LinkedIn group: https://linkedin.com/in/eplabdigest

    “I think it is very difficult to deny care to someone based on age. However, there are age limits on organ transplants. I think that we cannot expect the government to pay for ICDs in an aging population in which sudden death may not be so sudden after all. I do not know what that magic age should be for a primary prevention ICD, though. I think there will be more discussion on this issue in the near future.”     “One point made in the review; those over 80 had few or no co-morbidities prior to implant. The implication is that the increase in complication/morbidity rate was due to age and not underlying risk factors.    It also shows that MDs are screening > 80 patients prior to offering ICD/CRT therapies. The PARQ held with each patient prior to consent is a valuable part of the MD/patient relationship and seems to be working here. The high percentage of pre-screened 80 year olds in the study reflects the change in culture seen in the aging process that is now part of the U.S. Remember, 70 is the new 50, so 80 must be the new 60.    The conclusion statement gives me the most pause: “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.”¹    The prevalence and incidence of HF are increasing and the recent health care costs are soaring. Will this be the only criteria for patient selection in the future?”