Quality of life of patients over 80 years old with implantable cardioverter-defibrillators

Abstract

Implantable cardioverter-defibrillators (ICD) are frequently used to prevent sudden cardiac death. ICDs are underutilized in the elderly population. Though randomized trials included few elderly patients over the age of 80, ICDs should not be withheld on the basis of age alone as the available evidence shows a mortality benefit in this population. Complication rates in the elderly are slightly higher in the early post-implantation period but late complications are significantly lower. Elderly patients more likely to have complications can be identified prior to implantation through use of a validated risk score. There is a paucity of evidence regarding quality of life after ICD implantation but current evidence suggests it is comparable to patients who did not receive a device. Younger patients were more likely to experience psychological distress though elderly patients who experienced complications also experienced distress. Psychological distress can be well managed with cognitive- behavioral therapy. There is no conclusive evidence to suggest worse psychological well-being after ICD shocks and further evidence is needed in this field.