Comment on the article by Barra et al. entitled 'Implantable cardioverter-defibrillators in the elderly: rationale and specific age-related considerations'.

We congratulate Barra et al. on a thoughtful review of implantable cardioverter-defibrillators (ICDs) in the elderly.1 The article is timely given the increasing pressures of caring for an ageing population. It deals well with the issue of survival in elderly ICD recipients and the discussion on cost effectiveness is in line with what we had long suspected. We agree with many of the points raised in this review and would like to make two points: First, the comparison of an octogenarian ICD population with another (e.g. pacemaker) octogenarian ICD population is not valid as it is comparing two distinct entities, one …