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Permanent pacemakers in older persons.

G Gregoratos1

  • 1Cardiology Consultation Services, UCSF Stanford Medical Center, San Francisco, CA 94143-0327, USA.

Journal of the American Geriatrics Society
|September 14, 1999
PubMed
Summary
This summary is machine-generated.

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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.

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  • 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.