TY - JOUR T1 - Primary prevention implantable cardioverter defibrillators are effective in preventing overall mortality in older patients JF - Evidence Based Medicine JO - Evid Based Med SP - 217 LP - 217 DO - 10.1136/ebmed-2015-110281 VL - 20 IS - 6 AU - Sana M Al-Khatib Y1 - 2015/12/01 UR - http://ebm.bmj.com/content/20/6/217.abstract N2 - Commentary on: Chen CY, Stevenson LW, Stewart GC, et al. Real world effectiveness of primary implantable cardioverter defibrillators implanted during hospital admissions for exacerbation of heart failure or other acute co-morbidities: cohort study of older patients with heart failure. BMJ 2015;351:h3529OpenUrlAbstract/FREE Full Text.The implantable cardioverter defibrillator (ICD) is a life-saving therapy in patients with systolic heart failure. This benefit was first demonstrated by randomised clinical trials that enrolled outpatients who had well-controlled heart failure. Therefore, when those trials were published, it was not clear whether the results would apply to patients seen in clinical practice who might be older and sicker. Consequently, several studies reported on the outcomes of the ICD in clinical practice with one study showing no significant difference in survival between clinical trial ICD patients and a similar group of clinical practice ICD patients.1 The analysis by Chen … ER -