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Permanent pacing in the elderly

H D Strauss, N D Berman

    Pacing and Clinical Electrophysiology : PACE
    |October 1, 1978
    PubMed
    Summary
    This summary is machine-generated.

    Permanent pacemaker implantation in patients aged 80 and older demonstrates therapeutic benefits. This study found that pacing in the elderly is rewarding, with most patients becoming asymptomatic and not experiencing excess morbidity.

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    Area of Science:

    • Geriatric Cardiology
    • Cardiac Electrophysiology

    Background:

    • Elderly patients often present with symptomatic bradycardia requiring pacemaker implantation.
    • The safety and efficacy of permanent pacemaker (PPM) implantation in the very elderly population (≥80 years) require further investigation.

    Purpose of the Study:

    • To evaluate the outcomes of permanent pacemaker implantation in patients aged 80 years or older.
    • To assess the therapeutic benefits, complications, and long-term survival in this specific demographic.

    Main Methods:

    • Retrospective analysis of 89 patients aged 80+ undergoing initial permanent pacemaker implantation.
    • Follow-up duration ranged from 10 to 128 months (mean 32.7 months).
    • Data collected included demographics, pre- and post-implantation symptoms, complications, and pulse generator replacements.

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    Main Results:

    • The mean age of patients was 84.8 years, with 51 patients aged 80-84, 25 aged 85-89, and 13 aged 90-94.
    • The actuarial 5-year survival rate was 45%.
    • Complications occurred in 23 patients (40 episodes), and 41 patients required at least one pulse generator replacement. Most patients (86/89) were symptomatic before pacing, and 56 were asymptomatic at follow-up.

    Conclusions:

    • Permanent pacemaker implantation in the elderly (≥80 years) is a therapeutically beneficial procedure.
    • The procedure is not associated with excessive morbidity in this age group.
    • Pacing effectively alleviates symptoms and improves quality of life in very elderly patients.