{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T04:01:55Z","timestamp":1782360115494,"version":"3.54.5"},"reference-count":65,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,12,23]],"date-time":"2019-12-23T00:00:00Z","timestamp":1577059200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","award":["19CDA34760126"],"award-info":[{"award-number":["19CDA34760126"]}],"id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01HL136403"],"award-info":[{"award-number":["R01HL136403"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Most implantable cardioverter defibrillators (ICDs) are implanted for the purpose of primary prevention of sudden cardiac death among older patients with heart failure with reduced ejection fraction. Shared decision\u2010making prior to device implantation is guideline\u2010recommended and payer\u2010mandated. This article summarizes patient and provider attitudes toward device placement, device efficacy and effectiveness, potential periprocedural complications, long\u2010term events such as shocks, quality of life, costs, and shared decision\u2010making principles and recommendations. Most patients eligible for an ICD anticipate more than 10\u2009years of survival. Physicians are less likely to offer an ICD to patients \u226580\u2009years of age given a perceived lack of benefit. There is a dearth of data from randomized clinical trials addressing device efficacy among older patients; there is a need for more research in this area. However, currently available data support the use of ICDs irrespective of age provided life expectancy exceeds 1 year. Advanced age is independently associated with complications at the time of device placement but not the risk of device infection. The risk of inappropriate shock may be comparable or lower than that of younger patients. While quality of life is generally not adversely impacted by an ICD, a subset of patients experience post\u2010traumatic stress disorder. ICDs are cost\u2010effective from societal and health care sector perspectives; however, out\u2010of\u2010pocket costs vary according to insurance type and level. Shared decision\u2010making encounters may be incremental and iterative in nature. Providers are encouraged to partner with their patients, providing them counsel tailored to their values, preferences, and clinical presentation inclusive of age.<\/jats:p>","DOI":"10.1002\/clc.23315","type":"journal-article","created":{"date-parts":[[2019,12,23]],"date-time":"2019-12-23T08:56:36Z","timestamp":1577091396000},"page":"187-195","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Decision\u2010making regarding primary prevention implantable cardioverter\u2010defibrillators among older adults"],"prefix":"10.1002","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3022-764X","authenticated-orcid":false,"given":"Paul L.","family":"Hess","sequence":"first","affiliation":[{"name":"Rocky Mountain Regional VA Medical Center  Aurora Colorado"},{"name":"Cardiology Section University of Colorado Anschutz Medical Campus  Aurora Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel D.","family":"Matlock","sequence":"additional","affiliation":[{"name":"Rocky Mountain Regional VA Medical Center  Aurora Colorado"},{"name":"Cardiology Section University of Colorado Anschutz Medical Campus  Aurora Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sana M.","family":"Al\u2010Khatib","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Duke University Medical Center  Durham North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,23]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.10.035"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2013.01.035"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2013.09.079"},{"key":"e_1_2_9_5_1","volume-title":"Federal Interagency Forum on Aging\u2010Related Statistics"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12100"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.021048"},{"key":"e_1_2_9_8_1","unstructured":"Centers for Medicare and Medicaid Services.Decision Memo for Implantable Cardioverter Defibrillators (CAG\u201000157R4);https:\/\/www.cms.gov\/medicare\u2010coverage\u2010database\/details\/nca\u2010decision\u2010memo.aspx?NCAId=288. Published February 8 2016. Accessed August 10 2019."},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2009.09.003"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-015-0173-2"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/pace.12433"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.3171"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/HCO.0000000000000464"},{"issue":"3","key":"e_1_2_9_14_1","first-page":"267","article-title":"Physicians' knowledge and attitudes regarding implantable cardioverter\u2010defibrillators","volume":"17","author":"Sherazi S","year":"2010","journal-title":"Cardiol J"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1542-474X.2010.00412.x"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-153-9-201011020-00009"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.5603\/CJ.2011.0005"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.114.001306"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1608029"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamacardio.2017.0630"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.028829"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032423"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0906431"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1009540"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2011.02011.x"},{"key":"e_1_2_9_26_1","unstructured":"clinicaltrials.gov.Cardiac Resynchronization in the Elderly. NCT03031847.https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03031847. Accessed November 24 2019."},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.157182"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.108.807123"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.109.884395"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.10.052"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.7326\/M13-1879"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jchf.2015.01.012"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.816884"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.02.036"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.07.028"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2014.12.013"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2011.10.030"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.114.001455"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h3529"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.115.002053"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.020677"},{"key":"e_1_2_9_42_1","unstructured":"clinicaltrials.gov.Efficacy and Safety of Implantable Cardioverter\u2010Defibrillator (ICD) Implantation in the Elderly. NCT02121158.https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02121158. Accessed August 10 2019."},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.12367"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.009081"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2017.09.001"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.2459\/JCM.0000000000000023"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2010.02991.x"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.008292"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.001442"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1211107"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.111.000054"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2013.10.046"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1177\/1474515117739619"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.65.11.1324"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.97.21.2129"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.03.032"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.581884"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000042"},{"key":"e_1_2_9_59_1","volume-title":"Crossing the quality chasm: a new health system for the 21st century","author":"Institute of Medicine Committee on Quality of Health Care in America","year":"2001"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1109283"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X08327066"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1037\/hea0000417"},{"key":"e_1_2_9_63_1","first-page":"CD001431","article-title":"Decision aids for people facing health treatment or screening decisions","volume":"4","author":"Stacey D","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_64_1","unstructured":"University of Colorado School of Medicine. Colorado Program for Patient Centered Decisions.www.patientdecisionaid.org. Accessed July 30 2019."},{"key":"e_1_2_9_65_1","unstructured":"clinicaltrials.gov. A Multicenter Trial of a Shared DECision Support Intervention for Patients Offered Implantable Cardioverter\u2010DEfibrillators. NCT03374891.https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03374891. Accessed August 6 2019."},{"key":"e_1_2_9_66_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2013.03.031"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fclc.23315","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.23315","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/clc.23315","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.23315","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T10:03:15Z","timestamp":1694080995000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.23315"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,12,23]]},"references-count":65,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2020,2]]}},"alternative-id":["10.1002\/clc.23315"],"URL":"https:\/\/doi.org\/10.1002\/clc.23315","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,12,23]]},"assertion":[{"value":"2019-08-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-11-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-12-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}