Long-term outcome of cardiac pacing in octogenarians and nonagenarians

Abstract

This large study of long-term cardiac pacing for bradycardia in octogenarians and nonagenarians showed a cumulative 5-year survival of ~50%, which compares with that of age- and sex-matched controls. These data suggest a beneficial impact of bradycardia pacing, restoring life expectancy to previous levels. The occurrence of PM complications during long-term follow-up is not infrequent with 18.1% of patients experiencing a PM-related complication during a mean of 5.8 years follow-up. The complication rate was not higher than in younger PM patients.

Prognostic Factors in Patients with an Implanted Pacemaker after 80 Years of Age in a 4-Year Follow-Up

“…The distribution of parameters in the study group (sex, age, and additional health conditions analysed) was comparable to that in previously examined populations of >80-year-olds [5,6,14,15,[18][19][20] . In contrast to the pre- viously quoted research studies, in this paper pharmacotherapy and selected laboratory parameters were analysed as well.…”

Pacemaker replacement in nonagenarians: Procedural safety and long-term follow-up

“…Among the study population, 37 patients (59.7%) died, mainly from unknown or cardiovascular causes, and survival rates were 84.2% at 1 year, 66.9% at 2 years and 22.7% at 5 years; the median survival time was 30.2 months. These mortality rates are similar to those described previously by Udo et al in a population of octogenarians and nonagenarians implanted for the first time (86%, 75% and 49% after 1, 2 and 5 years [5]), and in nonagenarian non-recipients of pacemakers [26].…”

“…Women, underweight patients, low-volume centres and operators, dual-chamber devices, upgrading or lead revision and emergency out-of-hours procedures have been associated with a higher risk of complications [10]. In patients aged > 80 years, Udo et al reported significant complication rates, mostly lead-related, of 9.8% within 2 months and 6.9% during long-term follow-up; these rates were not different to those in patients aged < 80 years [5]. Similarly, very elderly patients did not seem to have more complications than younger patients in other studies [11,12].…”

“…To date, only a few studies have specifically reported the long-term outcome of very elderly patients implanted with a cardiac pacemaker. In a recent study, Udo et al evaluated the outcome of pacemaker recipients aged > 80 years, and reported a cumulative 5-year survival of around 50% after implantation, with a complication rate of 18.1% [5].…”

Life expectancy after implantation of a first cardiac permanent pacemaker (1995–2008): A population-based study

“…However, survival for recipients without CVD matched that of the general population. This was also the case for the oldest old (octogenarians and nonagenarians) [3,4]. Similar findings for elderly patients without symptomatic heart disease were reported in earlier decades from a small study from Olmsted County, Minnesota [5], and survival for agesex-and comorbidity-matched Taiwanese nonagenarians implanted with PPMs from 2001-2012 was no worse than for controls [6].…”