Wednesday, January 19, 2011

Will Heart Implant Benefit Patients Aged 80 And Beyond?

If a person is diagnosed with heart failure, which is caused by the inability of the right and left chambers of the heart to pump sufficient amounts of blood around the body, he or she might be ordered by the doctor to go for cardiac resynchronization therapy (CRT).

CRT uses a specialized device implanted in the body to synchronize the contractions of the right and left ventricles of the heart, which pump the blood by using electrical stimulation. Studies have confirmed the benefits provided by CRT on appropriately selected patients and recent trials have also shown that such devices could save up to 36 percent of heart failure patients.

Nevertheless, a paper appeared on April 12, 2010 in the journal “Archives of Internal Medicine” argued that people age 80 and beyond who get a pacemaker or defibrillator are more likely to die in the hospital after the procedure than younger patients.

Most clinical trials conducted previously looked at implantable heart devices involving people in the 50s and 60s, though about a fifth of these implants were actually used in people over age 80.

Researchers from Saint Louis University School of Medicine analyzed data from 26,887 adults with heart failure who underwent implantation of a defibrillator or CRT device in 2004 or 2005. Results of their analysis showed that the death rate in the hospital was 0.7 percent among patients younger than 80, compared to 1.2 percent in those aged 80 to 85 and 2.2 percent in those older than 85. Patients age 80 and beyond accounted for nearly 18 percent of the procedures.

The findings have indicated that certain patient subgroups might not benefit from device implantation. For instance, using implantable cardioverter defibrillator (ICD) does not help patients with kidney failure and those with advanced heart failure live any longer.

ICD detects dangerous heart rhythms and automatically shock an errant heartbeat back into a normal rhythm. A pacemaker is a medical device, which uses electrical impulses, delivered by electrodes contacting the heart muscles, to regulate the beating of the heart.

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