Physical performance status predicts mortality in aging patients undergoing pacemaker implantation

Area of Science:

• Cardiology
• Geriatrics
• Clinical Outcomes

Background:

• Aging populations often require pacemaker implantation for bradyarrhythmia.
• Frailty and reduced physical performance are common in older adults.
• The impact of physical status on outcomes post-pacemaker implantation requires further investigation.

Purpose of the Study:

• To evaluate the association between frailty/physical performance and clinical outcomes in elderly patients undergoing pacemaker implantation.
• To determine if physical performance status predicts mortality after pacemaker implantation.

Main Methods:

• Prospective cohort study of patients aged over 70 years undergoing pacemaker implantation.
• Physical performance assessed using the Short Physical Performance Battery (SPPB) and Handgrip Strength Test at discharge and 1 year.
• Overall mortality was the primary endpoint; death or rehospitalization at 1 year was also analyzed.

Main Results:

• 71% of patients exhibited reduced physical performance (SPPB score <10).
• Overall mortality was 31% after a median follow-up of 46 months.
• Lower SPPB scores at discharge predicted increased mortality (aHR 0.91, P=0.02) and a higher risk of death or rehospitalization at 1 year (OR 4.05).

Conclusions:

• Reduced physical performance is a significant predictor of increased mortality in aging patients with bradyarrhythmia requiring pacemaker implantation.
• Identifying patients with poor physical performance (low SPPB scores) can help tailor interventions to improve outcomes.
• This study highlights the importance of assessing physical status in elderly pacemaker recipients.