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Intermediate-term mortality and incidence of ICD therapy in octogenarians after cardiac resynchronization therapy

摘要Background Clinical outcomes of cardiac resynchronization therapy (CRT) in patients over the age of 80 have not been well de-scribed.MethodsWe retrospectively identified 96 consecutive patients≥ 80 years old who underwent an initial implant or an upgrade to CRT, with or without defibrillator (CRT-Dvs. CRT-P), at our institution between January 2003 and July 2008. The control cohort consisted of 177 randomly selected patients < 80 years old undergoing CRT implant during the same time period. The primary efficacy endpoint was all-cause mortality at 36 months, assessed by Kaplan-Meier time to first event curves.Results In the octogenarian cohort, mean age at CRT implant was 83.1 ± 2.9 yearsvs. 60.1 ± 8.8 years among controls (P < 0.001). Across both groups, 70% were male, mean left ventricular ejection fraction (LVEF) was 24.8% ± 14.1% and QRS duration was 154 ± 24.8 ms, without significant differences between groups. Octo-genarians were more likely to have ischemic cardiomyopathy (74%vs. 37%,P < 0.001) and more likely to undergo upgrade to CRT instead of an initial implant (42%vs. 19%,P < 0.001). The rate of appropriate defibrillator shocks was lower among octogenarians (14%vs. 27%,P = 0.02) whereas the rate of inappropriate shocks was similar (3%vs. 6%,P = 0.55). At 36 months, there was no significant difference in the rate of all-cause mortality between octogenarians (11%) and controls (8%,P = 0.381).ConclusionAppropriately selected octogenarians who are candidates for CRT have similar intermediate-term mortality compared to younger patients receiving CRT.

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作者单位 Department of Medicine, Emory University School of Medicine, 1364 Clifton Road Atlanta, GA 30322, USA [1] Division of Cardiology, Section of Electrophysiology, Emory University School of Medicine, Medical 0ffice Tower, 550 Peachtree Street, Atlanta, GA 30308, USA [2] Cardiology Clinical Databases, Emory Healthcare, 1364 Clifton Road F402, Atlanta, GA 30322, USA [3] Division of Cardiology, Section of Electrophysiology, Emory University School of Medicine, 1364 Clifton Road, Atlanta, GA 30322, USA [4]
DOI 10.11909/j.issn.1671-5411.2014.03.014
发布时间 2014-10-12
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老年心脏病学杂志(英文版)

老年心脏病学杂志(英文版)

2014年3期

180-184页

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