Abstract 12133: Survival in the Elderly Undergoing Cardiac Resynchronization Therapy
Background: Recently, higher in-hospital mortality rates in elderly recipients of biventricular pacemakers and ICDs have questioned the application of device therapy in octogenarians. As elderly patients eligible for device therapy are a particularly high risk group, we aimed to determine the long term survival in a “real world” cohort of octogenarians undergoing cardiac resynchronization therapy (CRT).
Methods: We extracted clinical data on a cohort of 800 consecutive patients undergoing the new implantation of a CRT device at between 4/15/2004 and 8/6/2007. Patients without a valid US Social Security number were excluded. The cohort was separated into three groups based on age(years old) at time of CRT implant: ≥80, 70–79, and < 70. Mean survival times were calculated for the three groups and Kaplan Meier curves were generated to make a comparison of survival.
Results: 763 patients met inclusion criteria in the following age groups: 430 <70, 235 70–79, and 98 ≥80. 94.5% of patients had an ICD. Over a mean follow up of 3.6±1.5 years, there were 266 deaths, 123 in patients <70, 96 between ages 70–79, and 47 ≥80. The mean survival times (years) were 4.8 (95%CI 4.6–5.0), 4.3 (95%CI4.0–4.6), and 4.1 (95%CI3.7–4.5) for the three groups in ascending order, respectively. Patients <70 had increased survival compared to the other two groups; however there was no significant survival difference between patients 70–79 and those ≥80 (log rank p= 0.27).
Conclusions: Octogenarians undergoing CRT have a reasonable mean survival time comparable to that seen in patients between 70 and 80 years of age. Therefore, octogenarians should not be refused CRT based on age alone.
- © 2010 by American Heart Association, Inc.