Age and Effectiveness of Prophylactic Implantable Cardioverter-Defibrillators
Authors: Pasquale Santangeli, Luigi Di Biase, Andrea Natale
Journal: Annals of Internal Medicine (2011)

Letters5 April 2011Age and Effectiveness of Prophylactic Implantable Cardioverter-DefibrillatorsPasquale Santangeli, MD, Luigi Di Biase, MD, PhD, and Andrea Natale, MDPasquale Santangeli, MDFrom Catholic University of the Sacred Heart, 00168 Rome, Italy; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX 78705; and Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX 78705.Search for more papers by this author, Luigi Di Biase, MD, PhDFrom Catholic University of the Sacred Heart, 00168 Rome, Italy; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX 78705; and Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX 78705.Search for more papers by this author, and Andrea Natale, MDFrom Catholic University of the Sacred Heart, 00168 Rome, Italy; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX 78705; and Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX 78705.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-154-7-201104050-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciated Drs. Barsheshet and Goldenberg's letter. We fully agree that comorbid conditions may play a significant role in determining the survival benefit of prophylactic ICD therapy (1). As such, we clearly stated in the abstract, introduction, and discussion sections of our article that the lack of adjustment for comorbid conditions may be a potential limitation of our analysis.We respectfully disagree that MADIT-II subgroup analyses sufficiently provide consistent evidence that age does not attenuate the benefit of ICD therapy (1). Drs. Barsheshet and Goldenberg state that the benefit of ICD in MADIT-II was “most prominent” among patients ...References1. Goldenberg I, Moss AJ. Treatment of arrhythmias and use of implantable cardioverter-defibrillators to improve survival in elderly patients with cardiac disease. Heart Fail Clin. 2007;3:519-28. [PMID: 17905386] CrossrefMedlineGoogle Scholar2. Cochrane Handbook for Systematic Reviews of Interventions, Version 5. 0.1. Updated September 2008. The Cochrane Collaboration; 2008. Accessed at www.cochrane-handbook.org/ on 10 December 2010. Google Scholar3. Randomised trial of intravenous streptokinase, oral aspirin, both, or neither among 17,187 cases of suspected acute myocardial infarction: ISIS-2. ISIS-2 (Second International Study of Infarct Survival) Collaborative Group. Lancet. 1988;2:349-60. [PMID: 2899772] MedlineGoogle Scholar4. Horton R. From star signs to trial guidelines. Lancet. 2000;355:1033-4. [PMID: 10744086] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Catholic University of the Sacred Heart, 00168 Rome, Italy; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX 78705; and Texas Cardiac Arrhythmia Institute, St. David's Medical Center, Austin, TX 78705.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-0999. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMeta-analysis: Age and Effectiveness of Prophylactic Implantable Cardioverter-Defibrillators Pasquale Santangeli , Luigi Di Biase , Antonio Dello Russo , Michela Casella , Stefano Bartoletti , Pietro Santarelli , Gemma Pelargonio , and Andrea Natale Age and Effectiveness of Prophylactic Implantable Cardioverter-Defibrillators Alon Barsheshet and Ilan Goldenberg Metrics Cited ByEffectiveness of Implantable Cardioverter Defibrillators for Primary Prevention of Sudden Cardiac Death in Subgroups A Systematic ReviewAmy Earley, BS, Rebecca Persson, BS, Ann C. Garlitski, MD, Ethan M. Balk, MD, MPH, and Katrin Uhlig, MD, MS 5 April 2011Volume 154, Issue 7Page: 505-506KeywordsConflicts of interestDisclosureElderlyMyocardial infarctionSurvival analysis ePublished: 5 April 2011 Issue Published: 5 April 2011 CopyrightCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...