Long-term outcome of cardiac pacing in octogenarians and nonagenarians.
OBJECTIVE
The number of patients >80 years receiving pacemakers (PMs) is increasing. Little is known about survival and complications in this specific subgroup. We aim to determine predictors of long-term survival.


RESULTS
Pacemaker-related complications and death occurring in patients receiving a first PM for conventional bradycardia indications were systematically documented (the FollowPace registry). This report describes 481 patients ≥80 years during a mean follow-up of 5.8 (SD 1.2) years. Within 2 months 54 PM complications occurred in 47 patients (9.8%). During follow-up, 35 adverse PM events were reported in 33 patients (6.9%). Complication rates in patients ≥80 years were comparable with those for patients <80 years. Survival rates were 86, 75, and 49% after 1, 2, and 5 years, respectively, and were comparable with survival for age- and sex-matched controls from the general Dutch population. Most patients died of non-cardiac causes. Age at the time of implantation, male gender, the presence of congestive heart failure, coronary pathology, and diabetes mellitus were independent predictors of all-cause mortality.


CONCLUSIONS
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.
Department of Cardiology, UMC Utrecht, Heidelberglaan 100, Utrecht, The Netherlands. e.o.udo@umcutrecht.nl
Erik O
EO
Udo
Norbert M
NM
van Hemel
Nicolaas P A
NP
Zuithoff
Johannes C
JC
Kelder
Har A
HA
Crommentuijn
Atie M
AM
Koopman-Verhagen
Theo
T
Voskuil
Pieter A F M
PA
Doevendans
Karel G M
KG
Moons
D000369:Aged, 80 and over; D001919:Bradycardia / Q000401:mortality* / Q000517:prevention & control*; D002304:Cardiac Pacing, Artificial / Q000401:mortality*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome