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Increasing age is associated with recurrent ventricular tachyarrhythmias and appropriate ICD therapies secondary to documented index ventricular tachyarrhythmias

  • Kathrin Weidner
  • Michael BehnesEmail author
  • Christel Weiß
  • Christoph Nienaber
  • Tobias Schupp
  • Linda Reiser
  • Armin Bollow
  • Gabriel Taton
  • Thomas Reichelt
  • Dominik Ellguth
  • Niko Engelke
  • Jonas Rusnak
  • Seung-hyun Kim
  • Christian Barth
  • Muharrem Akin
  • Kambis Mashayekhi
  • Martin Borggrefe
  • Ibrahim Akin
Research Paper
  • 3 Downloads

Key Summary Points

Aim

The study sought to assess the impact of age on recurrent ventricular tachyarrhythmias, appropriate ICD therapies and all-cause mortality at 5 years in consecutive ICD recipients.

Findings

Age ≥ 75 years was associated with higher rates of first recurrent ventricular tachyarrhythmias, appropriate ICD therapies and all-cause mortality at 5 years.

Message

Elderly ICD recipients aged ≥ 75 years are at increased risk of recurrent ventricular tachyarrhythmias, appropriate ICD therapies and all-cause mortality at 5 years.

Abstract

Background

Data regarding the prognostic impact of age in implantable cardioverter defibrillator (ICD) recipients is limited.

Objective

The study sought to assess the impact of age on recurrences of ventricular tachyarrhythmias in ICD recipients.

Methods

This “secondary prevention” study is based on a large retrospective registry including consecutive ICD recipients with documented ventricular tachyarrhythmias from 2002 to 2016. Patients < 75 years of age were compared to patients ≥ 75 years. The primary endpoint was first recurrence of ventricular tachyarrhythmias at 5 years. Secondary endpoints were ICD-related therapies, rehospitalization, and all-cause mortality at 5 years. Statistics comprised Kaplan–Meier survival curves, multivariable Cox regression analyses, and propensity-score matching.

Results

A total of 592 consecutive ICD recipients with index ventricular tachyarrhythmias was included (< 75 years: 78%; ≥ 75 years 22%). Age ≥ 75 years was associated with the primary endpoint of first recurrence of ventricular tachyarrhythmias (49% vs. 43%, log-rank p = 0.015; HR 1.418; 95% CI 1.070–1.881; p = 0.015), and with the secondary endpoint of first appropriate ICD therapy (78% vs. 22%, log-rank p = 0.011) even within multivariable Cox regression analyses. After propensity-score matching, age ≥ 75 years was still associated with the primary endpoint of first recurrence of ventricular tachyarrhythmias (49% vs. 42%, log-rank p = 0.045; HR 1.482; 95% CI 1.007–2.182; p = 0.046).

Conclusion

Elderly ICD recipients aged ≥ 75 years are at increased risk of recurrent ventricular tachyarrhythmias, appropriate ICD therapies, and all-cause mortality at 5 years.

Keywords

Recurrences Ventricular tachyarrhythmias Mortality Age ICD 

Notes

Compliance with ethical standards

Conflict of interest

There is no potential conflict of interests to disclose for any author.

Ethical approval

This study is based on a retrospective data analysis/registry and has been approved by the local ethics commission II of the faculty of Medicine Mannheim, University of Heidelberg (ethical approval number 2016-612NMA) (ClinicalTrials.govidentifier: NCT02982473).

Informed consent

No informed consent was deemed necessary for this study.

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Copyright information

© European Geriatric Medicine Society 2019

Authors and Affiliations

  • Kathrin Weidner
    • 1
  • Michael Behnes
    • 1
    Email author
  • Christel Weiß
    • 2
  • Christoph Nienaber
    • 3
  • Tobias Schupp
    • 1
  • Linda Reiser
    • 1
  • Armin Bollow
    • 1
  • Gabriel Taton
    • 1
  • Thomas Reichelt
    • 1
  • Dominik Ellguth
    • 1
  • Niko Engelke
    • 1
  • Jonas Rusnak
    • 1
  • Seung-hyun Kim
    • 1
  • Christian Barth
    • 1
  • Muharrem Akin
    • 4
  • Kambis Mashayekhi
    • 5
  • Martin Borggrefe
    • 1
  • Ibrahim Akin
    • 1
  1. 1.First Department of MedicineUniversity Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, European Center for AngioScience (ECAS), and DZHK (German Center for Cardiovascular Research) partner site Heidelberg/Mannheim, Mannheim, GermanyMannheimGermany
  2. 2.Institute of Biomathematics and Medical StatisticsUniversity Medical Center Mannheim (UMM), Faculty of Medicine Mannheim, Heidelberg UniversityMannheimGermany
  3. 3.Royal Brompton and Harefield Hospitals, NHSLondonUK
  4. 4.Department of Cardiology and AngiologyHannover Medical SchoolHannoverGermany
  5. 5.Clinic for Cardiology and Angiology IIUniversitaetszentrum Freiburg Bad Krozingen, University of FreiburgBad KrozingenGermany

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