Long-term prognosis of patients older than ninety years after permanent pacemaker implantation: Does the procedure save the patients?

Tze Fan Chao, Chia Jen Liu, Ta Chuan Tuan*, Jo Nan Liao, Yenn Jiang Lin, Tzeng Ji Chen, Chi Woon Kong, Shih Ann Chen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Background: The implantation of a permanent pacemaker (PPM) is life-saving for patients with life-threatening bradycardia. However, the effectiveness and prognosis of PPM implantations for extremely old patients (≥ 90 years old) have not been investigated. Methods: From 2001-2012, a total of 108 patients older than 90 years were identified from 2630 consecutive patients receiving PPM implantations in our hospital as the study group. For each study patient, 4 age-, sex-, and comorbidity-matched subjects who did not have the diagnoses of bradyarrhythmias indicated for PPM implantations were selected from the "Taiwan National Health Research Database" to constitute the control group (n= 432). The study end point was all-cause mortality. Results: The median age of the study population was 91 (interquartile range, 90-93) years. Among the PPM group, 45 patients died during the follow-up with an annual mortality rate of 18.7%. The risk of mortality did not differ significantly between the study and control groups with a hazard ratio of 1.020 (95% confidence interval, 0.724-1.437; P= 0.912) after the adjustment for age and sex. Procedure-related complications occurred in 7.4% of the patients receiving PPM implants, and pocket hematoma was the most common. The preimplantation history of heart failure and cerebrovascular accident, rather than age, were significant predictors of mortality among PPM recipients. Conclusions: Nonagenarians with severe bradyarrhythmias could retain the same life expectancies as those without bradyarrhythmias through PPM implantations. Extremely old age (≥90 years) should not be a barrier for PPM implants when indications are present.

Original languageEnglish
Pages (from-to)1196-1201
Number of pages6
JournalCanadian Journal of Cardiology
Volume30
Issue number10
DOIs
StatePublished - 1 Oct 2014

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