title: Falls and fractures in the elderly with sinus node disease: the impact of pacemaker implantation.
abstract: Background. Falls and fractures in the elderly are among the leading causes of disability. We investigated whether pacemaker implantation prevents falls in patients with SND in a large cohort of patients. Methods. Patient demographics and medical history were collected prospectively. Fall history was retrospectively reconstituted from available medical records. The 10-year probability for major osteoporotic fractures was calculated retrospectively from available medical records using the Swiss fracture risk assessment tool FRAX-Switzerland. Results. During a mean observation period of 2.3 years after implantation, the rates of fallers and injured fallers with fracture were reduced to 15% and 6%, respectively. This corresponds to a relative reduction in the number of fallers of 75% (P < 0.001) and of injured fallers of 63% (P = 0.014) after pacemaker implantation. Similarly, the number of falls was reduced from 60 (48%) before pacemaker implantation to 22 (18%) thereafter (relative reduction 63%, P = 0.035) and the number of falls with injury from 22 (18%) to 7 (6%), which corresponds to a relative reduction of 67%, P = 0.013. Conclusion. In patients with SND, pacemaker implantation significantly reduces the number of patients experiencing falls, the total number of falls, and the risk for osteoporotic fractures.
authors.affiliation: Clinic for Cardiology, University Hospital Zurich, Rämistrasse 100, B 8091 Zurich, Switzerland.
authors.forename: Nazmi
authors.initials: N
authors.lastname: Krasniqi
authors.forename: Diana
authors.initials: D
authors.lastname: Segalada
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lüscher
authors.forename: Kurt
authors.initials: K
authors.lastname: Lippuner
authors.forename: Laurent
authors.initials: L
authors.lastname: Haegeli
authors.forename: Jan
authors.initials: J
authors.lastname: Steffel
authors.forename: Thomas
authors.initials: T
authors.lastname: Wolber
authors.forename: Corinna
authors.initials: C
authors.lastname: Brunckhorst
authors.forename: Johannes
authors.initials: J
authors.lastname: Holzmeister
authors.forename: David
authors.initials: D
authors.lastname: Hürlimann
authors.forename: Firat
authors.initials: F
authors.lastname: Duru