Outcomes of elderly heart failure recipients of ICD and CRT

Implantable cardioverter defibrillator (ICD) therapy has been established as a highly effective method for primary and secondary prevention of sudden cardiac death in heart failure patients. In addition, cardiac resynchronization therapy (CRT) with and without defibrillator back-up improves symptoms, exercise capacity and prognosis in selected patients with advanced heart failure and intraventricular conduction delay. Unfortunately, mean patient age in ICD- and CRT-intervention trials was only 60 to 65 years with few patients being older than 75 years. None of these trials separately studied an elderly heart failure population. This review summarizes the available scientific evidence for the use of ICDs and CRT devices in elderly heart failure patients based on subgroup analyses of prospective randomized ICD- and CRT-intervention trials, and based on published cohort studies.