Most patients who have ICDs do not have a clear idea about the function and limitation of ICDs. Patient education about ICDs is an important aspect which deserves consideration, particularly in this age group.
The use of ICDs in octogenarians should be individualised and carefully scrutinised. It should take into consideration overall health status, symptom severity, co-morbidities and intermediate and long-term prognosis. There should be detailed discussion about patient preference and expectations. Physicians must provide a realistic appraisal of potential benefits and risks and address device management issues at end of life. This discussion should also take place when ICD replacement is considered.