Atrial fibrillation history is statistically significantly associated with adverse major clinical outcomes in ICD-implanted HF patients .
Patients with AF have a higher risk of all-cause mortality , appropriate , and inappropriate ICD interventions compared with patients with no AF history .
AIMS To assess the association between atrial fibrillation ( AF ) and all-cause mortality and implantable cardioverter-defibrillators ( ICDs ) therapies  in heart failure ( HF ) patients with reduced ejection fraction and an ICD implanted .
Comparison of benefit and mortality of implantable cardioverter-defibrillator therapy in patients aged ≥75 years versus those <75 years.
Implantable cardioverter-defibrillator ( ICD ) therapy decreases arrhythmic and all-cause mortality in patients at high risk of sudden death . However , its clinical benefit in elderly patients is uncertain . The aim of this study was to assess the long-term efficacy of ICD treatment in elderly patients and to identify markers of successful ICD therapy and risk factors of mortality . We performed multivariate analysis of a prospect i ve long-term data base from 2 tertiary care centers including 936 consecutive patients with an ICD . Predictors of ICD therapy and risk factors for mortality were assessed in patients ≥75 years old at ICD implantation compared to younger patients . Mean follow-up time was 43 ± 40 months . Rates of ICD therapy were similar in the 2 age groups . No significant predictors of ICD therapy could be identified in older patients . Median estimated survival was 132 months in patients < 75 years and 81 months in those ≥75 years old ( p = 0.006 ) . Decreased ejection fraction ( hazard ratio 1.62 per 10 % decrease , p = 0.03 ) and impaired renal function ( hazard ratio 1.57 per 10 ml/kg/m(2 ) decrease in estimated glomerular filtration rate , p = 0.02 ) were independent risk factors of mortality in patients ≥75 years old . However , mortality of older patients was similar to that of the age-matched general population irrespective of delivery of ICD therapy . In conclusion , ICD therapy is effective for treatment of life-threatening arrhythmias in all age groups . However , prevention of sudden cardiac death may have limited impact on overall mortality in older patients . Despite a similar rate of appropriate ICD therapies , risk of death is increased 1.6-fold in ICD recipients ≥75 years old compared to younger patients . Patients with decreased ejection fraction and impaired renal function are at highest risk
Atrial fibrillation history is statistically significantly associated with adverse major clinical outcomes in ICD-implanted HF patients .
Patients with AF have a higher risk of all-cause mortality , appropriate , and inappropriate ICD interventions compared with patients with no AF history .
AIMS To assess the association between atrial fibrillation ( AF ) and all-cause mortality and implantable cardioverter-defibrillators ( ICDs ) therapies  in heart failure ( HF ) patients with reduced ejection fraction and an ICD implanted .