Primary prevention implantable cardioverter-defibrillator implantation in elderly patients: is it justified to withhold treatment?

Implementation of primary prevention implantable cardioverter-defibrillator (ICD) treatment in the current clinical guidelines led to a significant increase in patients that may benefit from implantation of an ICD. Currently non-guideline-guided patient selection takes place by physicians whereby patients at higher age are more frequently excluded for ICD implantation. This editorial focuses on ICD treatment in the elderly and aims to clarify whether it is justified to withhold ICD treatment in these patients.