[Permanent pacemaker therapy in a community with many elderly people]

To clarify the utility of permanent pacemakers in a society composed largely of elderly people, clinical characteristics, pacemaker characteristics, outcome, and quality of life in a total of 116 patients in a community with many (19.6%) elderly people were evaluated after permanent pacemaker implantation. Patients above age 65 accounted for 88.8%, while those above 80 years accounted for 24.1%. Syncope was the most common observation before pacemaker implantation and emergency care was needed in 35% of patients. Sick sinus syndrome and complete AV block were seen in a majority, while atrial fibrillation with bradycardia was seen in a minority of patients. Although the physiological pacing and ventricular pacing mode (VVI) were used in about 50% each, recently the physiological pacing mode has markedly increased. During the mean follow-up of 26.1 +/- 16.2 months, only four patients died. NYHA 3 symptom improved to NYHA 1 after pacemaker implantation and 72.5% patients of all cases returned to their jobs. We conclude that the permanent pacemaker is effective in improving symptoms and reducing the death rate in elderly patients.