Arrhythmias & electrophysiology
Age and the Risk of Ventricular Tachyarrhythmia in Patients With an Implantable Cardioverter-Defibrillator
Pooled result · Cumulative incidence of fast VTAResult — go to the resultHazard ratio 0.60 95% CI 0.46–0.78Authors' conclusion
Patients ≥75 years of age have a significantly lower risk for VTA and ICD shocks compared with younger patients. Aging is associated with a higher risk for death compared with the risk for fast VTA, the reverse of what is seen in younger patients.
Study context
- Population
- Primary prevention ICD recipients enrolled in MADIT II, MADIT-Risk, MADIT-CRT, MADIT-RIT and RAID
- Participants
- 5,170 recipients5 ICD trials
- Comparison
- Age ≥75 years and 65 to <75 years vs <65 years
- Outcome
- Fast VTA (VT ≥200 beats/min or VF) vs death without prior fast VTA
- Follow-up
- 3 years
Methodological detailsFine and Gray competing-risk regression, 3 prespecified age groups
- Fine and Gray competing-risk regression
- 3 prespecified age groups
Pooled result
Cumulative incidence of fast VTA
Hazard ratio
0.60
95% CI 0.46–0.78
P < 0.001
By group
≥75 yearsvs <65 years
HR 0.60 (95% CI 0.46–0.78); P < 0.001
As reported in the abstract
- Cumulative incidence across age groups
- P < 0.001
Further pooled results
Competing risk of death without prior fast ventricular tachyarrhythmia (VTA), ≥75 years
- Risk reversal: risk of death without prior fast VTA exceeded risk of fast VTA in ≥75 years
Predictors of fast VTA, ≥75 years
- History of nonsustained VT, male sex and nonischemic cardiomyopathy predicted fast VTA
Original publication
Age and the Risk of Ventricular Tachyarrhythmia in Patients With an Implantable Cardioverter-Defibrillator. JACC Clin Electrophysiol. Published 18 January 2023. doi:10.
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