Impact of Advanced Age on In-Hospital Outcomes Following Leadless Pacemaker Implantation

Leadless pacemaker implantation (LPMI) is increasingly used in advanced age groups. This study aimed to compare the outcomes of LPMI between octogenarians (age 80-89) and nonagenarians (age ≥ 90) versus younger patients (age ≤ 79).

Data from the National Inpatient Sample between 2018 and 2021 were analyzed for patients over 18 years old who underwent LPMI. Patients were stratified into age groups: younger patients (age ≤ 79), octogenarians (ages 80-89), and nonagenarians (age ≥ 90). Multivariate logistic regression models were employed to adjust for confounders.

Among 40 995 patients who underwent LPMI, 33.5% were octogenarians, 11.9% were nonagenarians, and 54.6% were ≤ 79 years of age. Nonagenarians exhibited significantly lower odds of in-hospital mortality (aOR = 0.257, 95% CI: 0.133-0.497), blood transfusion, pericardial complications, venous thromboembolism, and bleeding complications compared to patients aged ≤ 79 (All p < 0.05). However, they demonstrated no significant difference in the odds of removal/revision. Octogenarians showed no significant difference in the odds of in-hospital mortality or removal/revision compared to younger patients. However, they had significantly lower odds of blood transfusion (aOR = 0.678, 95% CI: 0.556-0.826), venous thromboembolism, and bleeding complications (All p < 0.05).

Our analysis reveals that nonagenarians who underwent LPMI demonstrated significantly lower odds of in-hospital mortality compared to younger patients, while octogenarians did not differ significantly in the odds of mortality.