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Permanent pacemakers in older persons
1Cardiology Consultation Services, UCSF Stanford Medical Center, San Francisco, CA 94143-0327, USA.
Journal of the American Geriatrics Society
|September 14, 1999
Summary
Permanent pacemaker implantation is common in older adults due to age-related conduction abnormalities. Dual-chamber pacemakers are preferred for maintaining synchrony, improving quality of life and reducing complications.
Area of Science:
- Cardiology
- Geriatrics
- Biomedical Engineering
Background:
- Physiologic changes in aging commonly lead to cardiac conduction abnormalities.
- Pacemaker implantation is a frequent intervention in elderly individuals.
- Understanding age-related changes is crucial for appropriate pacing strategies.
Purpose of the Study:
- Review physiologic changes necessitating pacemakers in the elderly.
- Summarize current pacemaker implantation guidelines.
- Explore novel pacemaker applications and technological advancements.
- Assess the cost-effectiveness of permanent pacing.
Main Methods:
- Comprehensive literature search of MEDLINE database.
- Manual review of bibliographies and manufacturer data.
- Emphasis on studies involving older populations.
Main Results:
- Aging increases the incidence of impulse generation and conduction abnormalities.
- 70-80% of pacemakers are implanted in individuals aged 65+.
- Dual-chamber and rate-responsive pacemakers offer significant benefits in older adults.
- Investigational uses include severe left ventricular dysfunction and cardiomyopathies.
Conclusions:
- Permanent pacing is safe, cost-effective, and indicated for various conduction disorders.
- Older adults benefit significantly from dual-chamber pacemakers due to atrial contribution to ventricular filling.
- Pacemaker technology continues to evolve, offering improved patient outcomes.
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