In:
Clinical Cardiology, Wiley, Vol. 41, No. 10 ( 2018-10), p. 1315-1321
Abstract:
The rate of pacemaker (PM) implantations is constantly growing. Since life expectancy of the population is projected to increase, a large number of nonagenarian patients will need PM implantation. We aimed at analyzing short‐ and long‐term outcomes after PM implantation in nonagenarians. Methods Patients aged ≥90 years referred for PM implantation from 2004 to 2017 were included. The primary clinical endpoint was total mortality. Secondary endpoints included procedure‐related and in‐hospital complications. Results A total of 172 patients were included (92.6 ± 2.1 years, from 90.0 to 101.4 years). Procedure duration was 50.0 ± 19.7 minutes. Most of the patients had VVI devices implanted (143 pts, 83.1%) and mean hospital stay was 3.5 ± 1.5 days. Nine patients (5.2%) had short‐term device‐related complications and 29 patients (16.8%) had post‐procedural complications, non‐related to the implantation, including four leading to patients' death. During a follow‐up of 22.5 months (interquartile range: 7.3‐38.0), 94 patients (54.7%) died. Survival rates were 82.9% (95% confidence interval [CI]: 76.0‐88.0), 73.7% (95% CI: 65.7‐80.1) and 37.5% (95% CI: 27.5‐47.5) after 1, 2, and 5 years, respectively. The Charlson comorbidity index was a predictive factor of procedural complications (odds ratio = 1.33; 95% CI: 1.05‐1.69, P = 0.02) while having a complication (hazard ratio [HR] = 4.04; 95% CI: 1.79‐9.11, P = 0.001) and atrial fibrillation (HR = 1.63; 95% CI: [1.02‐2.63], P = 0.043) were predictors of post‐implantation death. Conclusion PM implantation in nonagenarians is safe, with a low risk of procedural complications, but many comorbidities‐related complications can occur. Caution should be taken in this old and frail population since complications significantly impact patients' survival.
Type of Medium:
Online Resource
ISSN:
0160-9289
,
1932-8737
DOI:
10.1002/clc.2018.41.issue-10
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2048223-1
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