Special considerations for patients aged 80 years or over receiving pacemaker implantation / 中华老年医学杂志

ABSTRACT

Objective To investigate indications,pacing modes,pacing parameters and postoperative complications of pacemaker implantation for patients aged 80 years or over.Methods Patients were recruited on a continuous basis and were assigned into two groups,with 112 patients in the very elderly (80-90 years old) group and 484 patients in the elderly (60-79 years old) group,which served as the control.Follow-up observations with the two groups were conducted concerning indications,mode selection,pacing parameters and postoperative complications.Results Compared with the control group,the very elderly group showed1) a higher rate of coronary heart disease (58cases vs.163 cases or 51.8％ vs.33.7％ ; x2 =12.78,P＜0.01) ; 2) more single-chamber pacemaker implantations (63 cases vs.217 cases or 56.3％ vs.44.8％; x2=4.76,P＜0.05) and fewer dual-or multi-chamber pacemaker implantations (49 cases vs.267 cases or 43.8％ vs.55.2％ ; x2 =4.76,P＜0.05) ; 3) a higher rate of double bundles branch block (19 cases vs.31 cases or 17.0％ vs.6.4％ ; x2=13.20,P＜0.01); 4) a higher rate of postoperative acute cerebral infarction (x2 =8.34,P＜0.01) ; and 5) increased ventricular [(0.78±0.24)V vs.(0.55±0.16)V,P＜0.05]and atrial [(1.07±0.22)V vs.(0.84±0.28)V,P＜0.05]pacing thresholds.Conclusions Special considerations should be made when pacemaker implantation is planned for patients aged 80 or over.Pacemaker selection decisions ought to be based on a comprehensive evaluation of relevant clinical situations so that clinical benefits can be maximized.