7/27/2019 10Apr_Questions Raised About Heart Implants Past Age
80
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Questions raised about heart implants past age 80
Julie Steenhuysen Mon Apr 12, 2010 4:31pm EDT
CHICAGO (Reuters) - People age 80 and older who get a pacemaker
ordefibrillator are more likely to die in the hospital after the
procedurethan younger patients, raising questions about the risks
of theseimplants when used in very elderly people, U.S. researchers
said on Monday.
Most clinical trials looking at implantable heart devices
involve peoplein their 50s and 60s even though about a fifth of
these implants areused in people over age 80, a group often
overlooked in medical studies,the researchers said.
As such, little had been known about the benefits of these
devices inpeople over 80, according to the researchers.
The researchers analyzed data from 26,887 adults with heart
failure whounderwent implantation of a defibrillator or cardiac
resynchronizationtherapy device in 2004 or 2005.
Younger patients appeared better able to withstand the implants,
theysaid. The study found a death rate in the hospital of 0.7
percent among
patients younger than 80, compared to 1.2 percent in those aged
80 to 85and 2.2 percent in those older than 85.
Patients age 80 and older accounted for nearly 18 percent of the
procedures.
"It has become increasingly apparent that certain patient
subgroups maynot benefit from device implantation," Jason Swindle,
who was at SaintLouis University School of Medicine when the study
was conducted,reported in the journal Archives of Internal
Medicine.
For example, Swindle and colleagues said using implantable
cardioverterdefibrillators, or ICDs, in patients with kidney
failure and in thosewith advanced heart failure does not help them
live any longer.
ICDs detect dangerous heart rhythms and automatically shock an
errantheartbeat back into a normal rhythm. Pacemakers correct an
abnormallyslow heart beat.
Implants that combine features of both, called cardiac
resynchronizationtherapy devices, are used to get the heart to
contract in a stronger,more coordinated fashion.
Implantable heart devices, made by companies like Boston
ScientificCorp, St. Jude Medical and Medtronic, represent a global
market of $10billion.
While many studies have shown the devices help save lives, the
averageage of patients in major clinical trials ranged from 58 to
67 years,with few 80 year olds included.
In general, the researchers said, older people were more likely
thanyounger people to die after an implant. They also found older
patientshad slightly more complications related to the device
procedure.
"Given trends in the demographics of heart failure and the costs
ofdevice therapy, additional studies are required to clarify
the
