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Is cardiac resynchronisation therapy feasible, safe and beneficial in the very elderly?

OBJECTIVE: To evaluate whether cardiac resynchronisation therapy (CRT) implantation was feasible and safe in octogenarians and the association with symptoms. METHODS: Consecutive patients undergoing CRT implantation were recruited from two UK centers. Patients grouped according to age: < 80 &...

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Autores principales: Olechowski, Bartosz, Sands, Rebecca, Zachariah, Donah, Andrews, Neil P, Balasubramaniam, Richard, Sopher, Mark, Paisey, John, Kalra, Paul R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Science Press 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4605944/
https://www.ncbi.nlm.nih.gov/pubmed/26512240
http://dx.doi.org/10.11909/j.issn.1671-5411.2015.05.003
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author Olechowski, Bartosz
Sands, Rebecca
Zachariah, Donah
Andrews, Neil P
Balasubramaniam, Richard
Sopher, Mark
Paisey, John
Kalra, Paul R
author_facet Olechowski, Bartosz
Sands, Rebecca
Zachariah, Donah
Andrews, Neil P
Balasubramaniam, Richard
Sopher, Mark
Paisey, John
Kalra, Paul R
author_sort Olechowski, Bartosz
collection PubMed
description OBJECTIVE: To evaluate whether cardiac resynchronisation therapy (CRT) implantation was feasible and safe in octogenarians and the association with symptoms. METHODS: Consecutive patients undergoing CRT implantation were recruited from two UK centers. Patients grouped according to age: < 80 & ≥ 80 years. Baseline demographics, complications and outcomes were compared between those groups. RESULTS: A total of 439 patients were included in this study, of whom 26% were aged ≥ 80 years. Octogenarians more often received cardiac resynchronization therapy pacemaker in comparison to cardiac resynchronisation therapy-defibrillator. Upgrade from pacemaker was common in both groups (16% < 80 years vs. 22% ≥ 80 years, P = NS). Co-morbidities were similarly common in both groups (overall diabetes: 25%, atrial fibrillation: 23%, hypertension: 45%). More patient age ≥ 80 years had significant chronic kidney disease (CKD, estimated glomerular filtration rate < 45 mL/min per 1.73 m(2), 44% vs. 22%, P < 0.01). Overall complication rates (any) were similar in both groups (16% vs. 17%, P = NS). Both groups demonstrated symptomatic benefit. One-year mortality rates were almost four fold greater in octogenarians as compared with the younger cohort (13.9% vs. 3.7%, P < 0.01). CONCLUSIONS: CRT appears to be safe in the very elderly despite extensive co-morbidity, and in particular frequent severe CKD. Symptomatic improvement appears to be meaningful. Strategies to increase the appropriate identification of elderly patients with CHF who are potential candidates for CRT are required.
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spelling pubmed-46059442015-10-28 Is cardiac resynchronisation therapy feasible, safe and beneficial in the very elderly? Olechowski, Bartosz Sands, Rebecca Zachariah, Donah Andrews, Neil P Balasubramaniam, Richard Sopher, Mark Paisey, John Kalra, Paul R J Geriatr Cardiol Research Article OBJECTIVE: To evaluate whether cardiac resynchronisation therapy (CRT) implantation was feasible and safe in octogenarians and the association with symptoms. METHODS: Consecutive patients undergoing CRT implantation were recruited from two UK centers. Patients grouped according to age: < 80 & ≥ 80 years. Baseline demographics, complications and outcomes were compared between those groups. RESULTS: A total of 439 patients were included in this study, of whom 26% were aged ≥ 80 years. Octogenarians more often received cardiac resynchronization therapy pacemaker in comparison to cardiac resynchronisation therapy-defibrillator. Upgrade from pacemaker was common in both groups (16% < 80 years vs. 22% ≥ 80 years, P = NS). Co-morbidities were similarly common in both groups (overall diabetes: 25%, atrial fibrillation: 23%, hypertension: 45%). More patient age ≥ 80 years had significant chronic kidney disease (CKD, estimated glomerular filtration rate < 45 mL/min per 1.73 m(2), 44% vs. 22%, P < 0.01). Overall complication rates (any) were similar in both groups (16% vs. 17%, P = NS). Both groups demonstrated symptomatic benefit. One-year mortality rates were almost four fold greater in octogenarians as compared with the younger cohort (13.9% vs. 3.7%, P < 0.01). CONCLUSIONS: CRT appears to be safe in the very elderly despite extensive co-morbidity, and in particular frequent severe CKD. Symptomatic improvement appears to be meaningful. Strategies to increase the appropriate identification of elderly patients with CHF who are potential candidates for CRT are required. Science Press 2015-09 /pmc/articles/PMC4605944/ /pubmed/26512240 http://dx.doi.org/10.11909/j.issn.1671-5411.2015.05.003 Text en Institute of Geriatric Cardiology http://creativecommons.org/licenses/by-nc-sa/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License, which allows readers to alter, transform, or build upon the article and then distribute the resulting work under the same or similar license to this one. The work must be attributed back to the original author and commercial use is not permitted without specific permission.
spellingShingle Research Article
Olechowski, Bartosz
Sands, Rebecca
Zachariah, Donah
Andrews, Neil P
Balasubramaniam, Richard
Sopher, Mark
Paisey, John
Kalra, Paul R
Is cardiac resynchronisation therapy feasible, safe and beneficial in the very elderly?
title Is cardiac resynchronisation therapy feasible, safe and beneficial in the very elderly?
title_full Is cardiac resynchronisation therapy feasible, safe and beneficial in the very elderly?
title_fullStr Is cardiac resynchronisation therapy feasible, safe and beneficial in the very elderly?
title_full_unstemmed Is cardiac resynchronisation therapy feasible, safe and beneficial in the very elderly?
title_short Is cardiac resynchronisation therapy feasible, safe and beneficial in the very elderly?
title_sort is cardiac resynchronisation therapy feasible, safe and beneficial in the very elderly?
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4605944/
https://www.ncbi.nlm.nih.gov/pubmed/26512240
http://dx.doi.org/10.11909/j.issn.1671-5411.2015.05.003
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