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- Title
Comparison of prognosis and safety of pacemaker implantation in patients aged less than or 85 years and older.
- Authors
Matsuda, Yasuhiro; Masuda, Masaharu; Asai, Mitsutoshi; Iida, Osamu; Okamoto, Shin; Ishihara, Takayuki; Nanto, Kiyonori; Kanda, Takashi; Tsujimura, Takuya; Okuno, Shota; Hata, Yosuke; Uematsu, Hiroyuki; Mano, Toshiaki
- Abstract
<bold>Purpose: </bold>Cardiac conduction disturbance necessitating pacemaker implantation is common among elderly patients. However, patients often have comorbidities and increased frailty which may result in limited life prognosis and a high rate of procedure-related complications. We evaluated pacemaker implantation in older patients by comparing life prognosis and complication rate in patients aged ≥ and < 85 years.<bold>Methods: </bold>We retrospectively enrolled 262 consecutive patients who underwent initial pacemaker implantation for bradycardia (age, 77 ± 10 years old; male, 132 (50%); dual chamber pacemaker, 222 (85%) patients). Acute and long-term outcomes were compared between patients aged ≥ 85 and < 85 years. Primary outcome was a composite of all-cause death and severe procedure-related complications.<bold>Results: </bold>Seven (14%) patients aged ≥ 85 years (n = 50; 19%) were non-ambulatory. During 2-year follow-up, primary outcome (death or severe complication) occurred in 47 (18%). Freedom from primary outcome was similar between age groups (81.6% versus 80.8%; p = 0.98). Freedom from all-cause death and from severe complication in the study period were also similar (all-cause death, 91.6% versus 88.7%, p = 0.70; severe complication, 89.7% versus 91.5%, p = 0.75). On multivariate analysis, sick sinus syndrome (hazard ratio (HR) 2.7, 95% confidence interval (CI) 1.1-6.4, p = 0.03), immunosuppressant use (HR 21 (95% CI 3.3-134), p < 0.01), and high C-reactive protein (HR 1.5 (95% CI 1.2-1.9), p < 0.01) were independent predictors of primary outcome.<bold>Conclusions: </bold>Life prognosis and severe complication rates after pacemaker implantation were similar between patients aged ≥ and < 85 years.
- Subjects
OLDER patients; AGE groups; C-reactive protein; PROGNOSIS; BRADYCARDIA; MULTIVARIATE analysis
- Publication
Journal of Interventional Cardiac Electrophysiology, 2021, Vol 61, Issue 1, p171
- ISSN
1383-875X
- Publication type
journal article
- DOI
10.1007/s10840-020-00797-9