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Permanent Pacing in Nonagenarians Over 20‐Year Period
Author(s) -
ANTONELLI DANTE,
FREEDBERG NAHUM A.,
BUSHARI LIMOR I.,
FELDMAN ALEXANDER,
TURGEMAN YOAV
Publication year - 2015
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12499
Subject(s) - medicine , sick sinus syndrome , atrioventricular block , atrial fibrillation , cardiology , population , implant , surgery , environmental health
Life expectancy increases progressively and nonagenarians are a growing population. We report trends in pacing and long‐term outcome in nonagenarians over a 20‐year period in a single center compared with those of younger patients. Methods We retrospectively reviewed all the patients who underwent their first pacemaker implantation from January 1, 1991 to December 31, 2010 and were followed through December 31, 2013. Results During the study period, 1,009 patients underwent first pacemaker implantation: 45 patients were older than 90 years (mean age 92.5 ± 2.6) (4.5%); 21 were men. Battery replacement was performed in four patients in whom first implant was made at age ≥90 years (8.9%) and in 231 patients aged <90 (24%; P < 0.01). Syncope was the most common symptom leading to pacing, followed by dizziness and fatigue in all age groups; no significant difference of symptoms was found between patient age groups. In patients aged ≥90 atrioventricular block and atrial fibrillation with slow ventricular response were more frequent, while sick sinus syndrome and carotid sinus hypersensitivity were less frequent than in younger patients. Ventricular chamber pacemakers were implanted with significant growing frequency, according to the older patients' age. Neither the indication for pacemaker implantation nor pacing mode influenced survival. Conclusions Nonagenarians are a growing population. Symptoms leading to pacing in patients aged ≥90 were similar to those of younger patients, but different frequency was found in the electrocardiographic indications. Ventricular chamber pacemakers were significantly more implanted than dual‐chamber pacemakers but without negative survival influence.