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

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An Editorial to this article was published on 04 June 2019

Key Summary Points

AbstractSection 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.

AbstractSection Findings

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

AbstractSection 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.

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Author information

Author notes

  1. Kathrin Weidner and Michael Behnes contributed equally to this work.

Authors and Affiliations

  1. First Department of Medicine, University 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, Germany, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

    Kathrin Weidner, Michael Behnes, Tobias Schupp, Linda Reiser, Armin Bollow, Gabriel Taton, Thomas Reichelt, Dominik Ellguth, Niko Engelke, Jonas Rusnak, Seung-hyun Kim, Christian Barth, Martin Borggrefe & Ibrahim Akin

  2. Institute of Biomathematics and Medical Statistics, University Medical Center Mannheim (UMM), Faculty of Medicine Mannheim, Heidelberg University, Mannheim, Germany

    Christel Weiß

  3. Royal Brompton and Harefield Hospitals, NHS, London, UK

    Christoph Nienaber

  4. Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany

    Muharrem Akin

  5. Clinic for Cardiology and Angiology II, Universitaetszentrum Freiburg Bad Krozingen, University of Freiburg, Bad Krozingen, Germany

    Kambis Mashayekhi

Authors
  1. Kathrin Weidner
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  2. Michael Behnes
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  3. Christel Weiß
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  4. Christoph Nienaber
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  14. Christian Barth
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  15. Muharrem Akin
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  16. Kambis Mashayekhi
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  17. Martin Borggrefe
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  18. Ibrahim Akin
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Corresponding author

Correspondence to Michael Behnes.

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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).

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No informed consent was deemed necessary for this study.

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Weidner, K., Behnes, M., Weiß, C. et al. Increasing age is associated with recurrent ventricular tachyarrhythmias and appropriate ICD therapies secondary to documented index ventricular tachyarrhythmias. Eur Geriatr Med 10, 567–576 (2019). https://doi.org/10.1007/s41999-019-00178-0

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  • DOI: https://doi.org/10.1007/s41999-019-00178-0

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