[A series of cases--too old for a pacemaker?]

We report three patients with an age above 90 years presented with symptomatic bradycardia and higher grade AV block in our clinic. The oldest patient was 100 years. All three patients could be supplied safely and without complications with a dual chamber pacemaker. Our case series shows that a dual chamber pacemaker implantation is safe and feasible in patients in very advanced age. A surgical management with local anesthetic (lidocaine), fentanyl and midazolam in individual cases is possible. This and a short hospital stay reduce the risk of delirium. It is a group of patients, which will increase in the future and requires more intensive care than the standard pacemaker patient.