AHRQ Study: Older Patients May Not Benefit From Implantable Defibrillators

Older patients who receive a primary implantable cardioverter defibrillator (ICD) during acute hospitalizations may not have substantially different mortality or sudden cardiac death rates compared with those who are discharged without an ICD, according to an AHRQ-funded study published in BMJ. Receiving a primary ICD while hospitalized for heart failure or other acute conditions (representing approximately 40 percent of ICD implantations in Medicare patients) might not confer the same benefit demonstrated for patients in previous landmark trials, in which the candidates were selected in a stable outpatient setting and ICDs were received as an elective procedure. The BMJ study was based on data of more than 23,000 patients age 66 and older who were hospitalized between 2005 and 2008 for heart failure exacerbation or other acute comorbidities and were eligible for a primary ICD. More research is needed to identify subgroups of elderly patients who are more likely to benefit from ICDs, according to the authors. Read the study, “Real World Effectiveness of Primary Implantable Cardioverter Defibrillators Implanted During Hospital Admissions for Exacerbation of Heart Failure or Other Acute Co-Morbidities: Cohort Study of Older Patients.”