Treatment of Ventricular Arrhythmias and Use of Implantable Cardioverter-Defibrillators to Improve Survival in Older Adult Patients with Cardiac Disease

Jason T Jacobson; Sei Iwai; Wilbert S Aronow

doi:10.1016/j.hfc.2017.02.015

Treatment of Ventricular Arrhythmias and Use of Implantable Cardioverter-Defibrillators to Improve Survival in Older Adult Patients with Cardiac Disease

Heart Fail Clin. 2017 Jul;13(3):589-605. doi: 10.1016/j.hfc.2017.02.015. Epub 2017 May 2.

Authors

Jason T Jacobson¹, Sei Iwai¹, Wilbert S Aronow²

Affiliations

¹ Division of Cardiology, Department of Medicine, Westchester Medical Center, New York Medical College, Macy Pavilion, 100 Woods Road, Valhalla, NY 10595, USA.
² Division of Cardiology, Department of Medicine, Westchester Medical Center, New York Medical College, Macy Pavilion, 100 Woods Road, Valhalla, NY 10595, USA. Electronic address: wsaronow@aol.com.

PMID: 28602374
DOI: 10.1016/j.hfc.2017.02.015

Abstract

Ventricular arrhythmia (VA) and sudden cardiac death (SCD) are well-recognized problems in the overall heart failure population, but treatment decisions can be more complex and nuanced in older patients. Sustained VA does not always lead to SCD, but identifies a higher risk population and may cause significant symptoms. Antiarrhythmic drugs (AAD) and catheter ablation are the mainstays for prevention of VA, but have not been shown to improve mortality. The value of implantable cardiac defibrillators (ICDs) may be influenced by patient age. This article discusses long-term treatment of VA and the use of ICDs in the elderly.

Keywords: Ablation; Antiarrhythmic drugs; Autonomic modulation; ICD; Ventricular arrhythmia.

Publication types

Review

MeSH terms

Age Factors
Aged
Defibrillators, Implantable*
Humans
Randomized Controlled Trials as Topic
Survival Rate
Tachycardia, Ventricular / drug therapy
Tachycardia, Ventricular / therapy*
Ventricular Fibrillation / therapy