Poster No. 025 Survival in octogenarians receiving implantable cardiac defibrillators: a single centre experience

Although the efficacy of implantable cardiac defibrillator (ICD) in preventing sudden cardiac death is well established in studies, patients ≥ 80 years are poorly represented, causing a paucity of data on outcomes in this subgroup.

In our single-centre retrospective study, data pertaining to patients > or = 80 years of age at device implant (n = 95) between January 2010 and January 2022 was extracted from device databases and clinical notes. Categorical variables were compared using Fisher's exact test. A Kaplan-Meier survival analysis with logrank test was performed. A Multivariable Cox Hazard regression model was used to analyse survival adjusting for QRS duration, left ventricular ejection fraction and device type.

Mean age of the cohort was 83.1 ± 3 years, with 85% (n = 81) being male. 73% (n = 69) of the population had ischaemic cardiomyopathy and 43% (n = 41) met the primary prevention indications. Median survival time post device implantation was 27 months. Survival at 5 years was 80%. The difference in survival rates between primary and secondary prevention groups was not statistically significant. Inappropriate shocks were delivered in 2 patients while 14 patients were successfully treated with appropriate therapy. Complications were encountered in 9% (n = 9) of cases, with a fatal outcome on one occasion.

ICD therapy is a well-tolerated intervention and may confer survival benefits in elderly patients, provided careful selection criteria are implemented. Advanced chronological age alone should not unduly influence the decision for ICD selection for survival benefit. There is an imperative for greater representation of this cohort in future trials.