ABSTRACT
Background Clinical outcomes of cardiac resynchronization therapy (CRT) in patients over the age of 80 have not been well de-scribed.MethodsWe retrospectively identified 96 consecutive patients≥ 80 years old who underwent an initial implant or an upgrade to CRT, with or without defibrillator (CRT-Dvs. CRT-P), at our institution between January 2003 and July 2008. The control cohort consisted of 177 randomly selected patients < 80 years old undergoing CRT implant during the same time period. The primary efficacy endpoint was all-cause mortality at 36 months, assessed by Kaplan-Meier time to first event curves.Results In the octogenarian cohort, mean age at CRT implant was 83.1 ± 2.9 yearsvs. 60.1 ± 8.8 years among controls (P < 0.001). Across both groups, 70% were male, mean left ventricular ejection fraction (LVEF) was 24.8% ± 14.1% and QRS duration was 154 ± 24.8 ms, without significant differences between groups. Octo-genarians were more likely to have ischemic cardiomyopathy (74%vs. 37%,P < 0.001) and more likely to undergo upgrade to CRT instead of an initial implant (42%vs. 19%,P < 0.001). The rate of appropriate defibrillator shocks was lower among octogenarians (14%vs. 27%,P = 0.02) whereas the rate of inappropriate shocks was similar (3%vs. 6%,P = 0.55). At 36 months, there was no significant difference in the rate of all-cause mortality between octogenarians (11%) and controls (8%,P = 0.381).ConclusionAppropriately selected octogenarians who are candidates for CRT have similar intermediate-term mortality compared to younger patients receiving CRT.