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Comparison of prognosis and safety of pacemaker implantation in patients aged less than or 85 years and older

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusions

Life prognosis and severe complication rates after pacemaker implantation were similar between patients aged ≥ and < 85 years.

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Acknowledgments

We thank Guy Harris DO from DMC Corp. (www.dmed.co.jp <http://www.dmed.co.jp/>) for editing drafts of this manuscript.

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Authors and Affiliations

  1. Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo, 660-8511, Japan

    Yasuhiro Matsuda, Masaharu Masuda, Mitsutoshi Asai, Osamu Iida, Shin Okamoto, Takayuki Ishihara, Kiyonori Nanto, Takashi Kanda, Takuya Tsujimura, Shota Okuno, Yosuke Hata, Hiroyuki Uematsu & Toshiaki Mano

Authors
  1. Yasuhiro Matsuda
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  2. Masaharu Masuda
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  3. Mitsutoshi Asai
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  4. Osamu Iida
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  5. Shin Okamoto
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  6. Takayuki Ishihara
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  13. Toshiaki Mano
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Corresponding author

Correspondence to Masaharu Masuda.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This study complied with the Declaration of Helsinki. Written informed consent for pacemaker implantation and participation in the study was obtained from all patients, and the protocol was approved by our institution’s institutional review board.

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Matsuda, Y., Masuda, M., Asai, M. et al. Comparison of prognosis and safety of pacemaker implantation in patients aged less than or 85 years and older. J Interv Card Electrophysiol 61, 171–179 (2021). https://doi.org/10.1007/s10840-020-00797-9

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  • DOI: https://doi.org/10.1007/s10840-020-00797-9

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