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In Reply Dr Forman and colleagues make important points that increasing comorbidities in older patients may raise the risk of noncardiovascular death, and goals of care are often ill-defined in older patients with cardiovascular disease. We acknowledge the potential for residual, unmeasured confounding and selection bias in our observational analyses; however, our adjusted findings demonstrated that ICD use was consistently associated with lower mortality even in older individuals.
Pokorney SD, Peterson ED, Wang TY. Use of Implantable Cardioverter-Defibrillators Among Medicare Patients—Reply. JAMA. 2015;314(17):1874-1875. doi:10.1001/jama.2015.12218