Implantable cardioverter defibrillators improve survival in older heart patients



If you will exert too much pressure on a bone, more than the threshold pressure which it can tolerate, it will break. This is usually termed as bone fracture and is a very painful thing. Fractures are considered as a major form of injury. However, whether a person can recover from them depends on a

Full Post: Symptoms of a fracture

Implantable cardioverter defibrillators (ICDs) can improve survival in patients with heart damage - even those in their 70s - according to research reported in Circulation: Cardiovascular Quality and Outcomes.

Implanted ICDs reduced the risk of dying by 30 percent in patients younger than 65 years old, 65 to 74, and 75 and older, said Paul Chan, M.D., M.Sc., lead author of the study and assistant professor at the Mid-America Heart Institute and the University of Missouri in Kansas City.

Patients who have damaged heart muscle that results in diminished pumping action - called left ventricular systolic dysfunction - are candidates for ICDs to prevent death from life-threatening arrhythmias. The tiny devices are implanted under the skin and connected to the heart muscle by electrodes. An ICD automatically shocks the heart back into normal rhythm when the ICD detects life-threatening rhythms.

Previous studies of ICDs have been conducted in patients who are primarily younger than 75, and who have few complications such as diabetes, chronic obstructive lung disease or a history of stroke.

This primary prevention study recruited 986 consecutive patients who had diminished left ventricular function - meaning the pumping chamber of the heart was functioning at no more than 35 percent of capacity. Patients were treated from March 2001 though June 2005 and followed through March 2007.

Researchers compared outcomes of 500 patients who received ICDs to those who didn’t receive the devices. The median age of patients was 67. This was about seven years older than participants in an earlier study that investigated the use of ICDs in patients with heart failure (the SCD-HeFT trial) and about three years older than participants in a study that reported on the use of ICDs in patients who had heart attacks (the MADIT-2 trial).

Researchers said theirs was one of the first studies to examine whether the benefits of ICDs from controlled clinical trials apply to real-world patients. Their study was also the first to examine a clinically well-characterized primary prevention group with patients of both ischemic and non-ischemic causes of heart damage with more than three years of follow-up.

“We sought to determine the effectiveness of ICDs in real-world patients who are older and have multiple co-existing illnesses,” Chan said.

Overall, 238 deaths occurred - 130 (26.7 percent) in the non-ICD group and 108 (21.6 percent) in the ICD group. Of these, 116 were attributed to arrhythmia - 67 (13.7 percent) in the non-ICD group and 49 (9.8 percent) in the ICD group.

“The ICD reduced all-cause mortality by 30 percent compared with patients who didn’t receive ICDs,” Chan said. “The use of ICDs in general practice reduced mortality similar to the levels seen in clinical trials. And, the use of ICDs in older patients and patients with comorbidities reduced mortality both in relative and absolute terms.”

When researchers studied patients age 75 or older, they found that the level of survival benefit remained intact. But the benefit diminished when age was combined with multiple disease conditions.

The caveat, Chan said, was that “cost effectiveness estimates for ICD therapy in this study population depended upon both the degree and the number of comorbidities.” Chan and his colleagues also reported in the paper cost-effectiveness estimates for the use of ICD therapy by age and comorbidity subgroups.

The study was limited because of the relatively few patients in their 80s. “I feel comfortable applying the findings to septuagenarians, but we continue to have limited data on ICD use among octogenarians,” Chan said.

http://www.americanheart.org/

Link




In recent years, women, particularly younger women, experienced larger improvements in hospital mortality after myocardial infarction than men, according to a new study. Over the last decade some studies showed that younger women, but not older ones, are more likely to die in the hospital after MI than age-matched men. A team of researchers led

Full Post: Sex differences narrow in death after heart attack



Headphones for MP3 players placed within an inch of pacemakers and implantable cardioverter defibrillators (ICDs) may interfere with these devices, according to research presented at the American Heart Association’s Scientific Sessions 2008. Researchers investigated the effects of MP3 player headphones, most of which contain the magnetic substance neodymium, on the operation of implanted cardiac devices

Full Post: Headphones for MP3 players interfere with heart defibrillators, pacemakers



Dr. Margaret Chan, WHO Director-General says a major milestone in the long struggle against HIV/AIDS has been reached. This year is the 20th anniversary of the emergence of the devastating disease and Dr. Chan says more than 3 million people in low and middle-income countries are now receiving life-prolonging antiretroviral therapy - an achievement which

Full Post: WHO boss says major milestone reached in fight against AIDS



Researchers at Children’s Hospital of Pittsburgh of UPMC have been able to effectively repair damaged heart muscle in an animal model using a novel population of stem cells they discovered that is derived from human skeletal muscle tissue. The research team - led by Johnny Huard, PhD - transplanted stem cells purified from human muscle-derived

Full Post: Researchers repair injured heart muscle with novel stem cells



UC San Diego Medical Center is currently enrolling patients in a Phase 2 clinical trial of an investigational drug for the treatment of advanced heart failure. The “Calcium Up-Regulation by Percutaneous Administration of Gene Therapy in Cardiac Disease,” or CUPID, study is evaluating a new gene-based therapy designed to stimulate production of an enzyme that

Full Post: Trial of investigational drug for treatment of advanced heart failure