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Implantable cardiac defibrillators in octogenarians

Journal of Geriatric Cardiology 2023年第1期20卷 23-31页

作者： Maarten Pauwelyn Sebastian Ingelaere Ruben Hoffmann Johan Vijgen Georges H.Mairesse Ivan Blankoff Yves Vandekerckhove jean-benoit le polain de waroux Bert Vandenberk Rik Willems University Hospitals leuven CardiologyLeuvenBelgium KU leuven Department of Cardiovascular SciencesLeuvenBelgium UZA Department of CardiologyAntwerpBelgium Jessa Ziekenhuis Department of CardiologyHasseltBelgium Cliniques du Sud Luxembourg Department of CardiologyArlonBelgium CHU Charleroi Department of CardiologyCharleroiBelgium AZ Sint-Jan Department of CardiologyBruggeBelgium University of Calgary Libin Cardiovascular InstituteCalgaryCanada

OBJECTIVE Implantable cardiac defibrillators(ICD)implantation in the very elderly remains *** aimed to describe the experience and outcome of patients over 80 years old implanted with an ICD in *** Data were extracted from the national QERMID-ICD *** implantations performed in octogenarians between February 2010 and March 2019 were *** on baseline patient characteristics,type of prevention,device configuration and all-cause mortality were *** determine predictors of mortality,multivariable Cox proportional hazard regression modelling was *** Nationwide,704 primo ICD implantations were performed in octogenarians(median age 82,IQR 81-83 years;83% male and 45% secondary prevention).During a mean follow-up of 3.1±2.3 years,249(35%)patients died,of which 76(11%)within the first year after *** multivariable Cox regression analysis age(HR=1.15,P=0.004),oncological history(HR=2.43,P=0.027)and secondary prevention(HR=2.23,P=0.001)were independently associated with 1-year mortality.A better preserved left ventricular ejection fraction(LVEF)was associated with a better outcome(HR=0.97,P=0.002).Regarding overall mortality multivariable analysis withheld age,history of atrial fibrillation,centre volume and oncological history as significant *** LVEF was again protective(HR=0.99,P=0.008).CONCLUSIONS Primary ICD implantation in octogenarians is not often performed in *** this population,11%died within the first year after ICD *** age,oncological history,secondary prevention and a lower LVEF were associated with an increased one-year ***,low LVEF,atrial fibrillation,centre volume and oncological history were indicative of higher overall mortality.

关键词： prevention implantation protective

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