10 Jan 10% of Patients Receiving Implantable Defibrillators Are Frail Or Have Dementia
MedicalResearch.com Interview with:
Ariel R. Green, M.D., M.P.H
Assistant Professor of Medicine
Johns Hopkins University School of Medicine
Medical Research: What is the background for this study? What are the main findings?
Response: Implantable cardioverter-defibrillators (ICDs) are widely used to prevent sudden cardiac death in patients with systolic heart failure. Older adults with heart failure often have multiple coexisting conditions and are frail, increasing their risk of death from non-cardiac causes. Our understanding of outcomes in older patients with ICDs is limited.
Medical Research: What should clinicians and patients take away from your report?
Response: Our major finding was that more than 10% of patients currently receiving ICDs for primary prevention of sudden cardiac death (meaning that they have never had a potentially lethal arrhythmia but are at risk for one, usually due to systolic heart failure) are frail or have dementia. Patients with these geriatric conditions had substantially higher mortality within the first year after ICD implantation than those without these conditions. Frailty and dementia were more strongly associated with mortality than were traditional comorbidities such as diabetes.
Medical Research: What recommendations do you have for future research as a result of this study?
Response: Our findings suggest that decision making regarding the use of ICDs should go beyond individual diseases and consider geriatric conditions such as frailty and dementia. Frailty screening may improve appropriate ICD utilization and patient outcomes.
Dr. Ariel Green Frank (2016). 10% of Patients Receiving Implantable Defibrillators Are Frail Or Have Dementia