Comparison of prognosis and safety of pacemaker implantation in patients aged less than or 85 years and older
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 implant...
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| Veröffentlicht in: | Journal of interventional cardiac electrophysiology 2021-06, Vol.61 (1), p.171-179 |
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| creator | Matsuda, Yasuhiro Masuda, Masaharu Asai, Mitsutoshi Iida, Osamu Okamoto, Shin Ishihara, Takayuki Nanto, Kiyonori Kanda, Takashi Tsujimura, Takuya Okuno, Shota Hata, Yosuke Uematsu, Hiroyuki Mano, Toshiaki |
| description | 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 |
| doi_str_mv | 10.1007/s10840-020-00797-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2412987232</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2412987232</sourcerecordid><originalsourceid>FETCH-LOGICAL-c418t-958ebdb6bf2c6edcf4e3296b6b142427a182fd6b2d7a601f48f7b39a23e6a60f3</originalsourceid><addsrcrecordid>eNp9UctKxDAULaLg-PgBVwU3bqp5tUmWMviCATcK7kLa3owd22RMOov5G7_FL_M6FQQXQi65nJxzuDcny84ouaSEyKtEiRKkIAyLSC0LvZfNaClZoUpd7mPPFS-ULF8Os6OUVoQQTVg1y_w8DGsbuxR8Hly-jmHpQ-pSbn2bJ-tg3O5w28Bg3yDm3bDurR_t2KGi8_gyduBHFCyhzXtIKR9fLZrFXJWfH1uwcTILfQvxJDtwtk9w-nMfZ8-3N0_z-2LxePcwv14UjaBqLHSpoG7rqnasqaBtnADOdIUAFUwwaalirq1q1kpbEeqEcrLm2jIOFQKOH2cXky8u9L6BNJqhSw30ODqETTJMUKaVZJwh9fwPdRU20eN0hpUCP0rhQRabWE0MKUVwZh27wcatocR8R2CmCAxGYHYRGI0iPokSkv0S4q_1P6ovmSKK9A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2540008008</pqid></control><display><type>article</type><title>Comparison of prognosis and safety of pacemaker implantation in patients aged less than or 85 years and older</title><source>SpringerLink Journals - AutoHoldings</source><creator>Matsuda, Yasuhiro ; Masuda, Masaharu ; Asai, Mitsutoshi ; Iida, Osamu ; Okamoto, Shin ; Ishihara, Takayuki ; Nanto, Kiyonori ; Kanda, Takashi ; Tsujimura, Takuya ; Okuno, Shota ; Hata, Yosuke ; Uematsu, Hiroyuki ; Mano, Toshiaki</creator><creatorcontrib>Matsuda, Yasuhiro ; Masuda, Masaharu ; Asai, Mitsutoshi ; Iida, Osamu ; Okamoto, Shin ; Ishihara, Takayuki ; Nanto, Kiyonori ; Kanda, Takashi ; Tsujimura, Takuya ; Okuno, Shota ; Hata, Yosuke ; Uematsu, Hiroyuki ; Mano, Toshiaki</creatorcontrib><description>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.</description><identifier>ISSN: 1383-875X</identifier><identifier>EISSN: 1572-8595</identifier><identifier>DOI: 10.1007/s10840-020-00797-9</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Bradycardia ; C-reactive protein ; Cardiology ; Complications ; Confidence intervals ; Death ; Implantation ; Medicine ; Medicine & Public Health ; Mortality ; Multivariate analysis ; Pacemakers ; Prognosis</subject><ispartof>Journal of interventional cardiac electrophysiology, 2021-06, Vol.61 (1), p.171-179</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020</rights><rights>Springer Science+Business Media, LLC, part of Springer Nature 2020.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c418t-958ebdb6bf2c6edcf4e3296b6b142427a182fd6b2d7a601f48f7b39a23e6a60f3</citedby><cites>FETCH-LOGICAL-c418t-958ebdb6bf2c6edcf4e3296b6b142427a182fd6b2d7a601f48f7b39a23e6a60f3</cites><orcidid>0000-0002-5566-466X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10840-020-00797-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10840-020-00797-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids></links><search><creatorcontrib>Matsuda, Yasuhiro</creatorcontrib><creatorcontrib>Masuda, Masaharu</creatorcontrib><creatorcontrib>Asai, Mitsutoshi</creatorcontrib><creatorcontrib>Iida, Osamu</creatorcontrib><creatorcontrib>Okamoto, Shin</creatorcontrib><creatorcontrib>Ishihara, Takayuki</creatorcontrib><creatorcontrib>Nanto, Kiyonori</creatorcontrib><creatorcontrib>Kanda, Takashi</creatorcontrib><creatorcontrib>Tsujimura, Takuya</creatorcontrib><creatorcontrib>Okuno, Shota</creatorcontrib><creatorcontrib>Hata, Yosuke</creatorcontrib><creatorcontrib>Uematsu, Hiroyuki</creatorcontrib><creatorcontrib>Mano, Toshiaki</creatorcontrib><title>Comparison of prognosis and safety of pacemaker implantation in patients aged less than or 85 years and older</title><title>Journal of interventional cardiac electrophysiology</title><addtitle>J Interv Card Electrophysiol</addtitle><description>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.</description><subject>Bradycardia</subject><subject>C-reactive protein</subject><subject>Cardiology</subject><subject>Complications</subject><subject>Confidence intervals</subject><subject>Death</subject><subject>Implantation</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Pacemakers</subject><subject>Prognosis</subject><issn>1383-875X</issn><issn>1572-8595</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp9UctKxDAULaLg-PgBVwU3bqp5tUmWMviCATcK7kLa3owd22RMOov5G7_FL_M6FQQXQi65nJxzuDcny84ouaSEyKtEiRKkIAyLSC0LvZfNaClZoUpd7mPPFS-ULF8Os6OUVoQQTVg1y_w8DGsbuxR8Hly-jmHpQ-pSbn2bJ-tg3O5w28Bg3yDm3bDurR_t2KGi8_gyduBHFCyhzXtIKR9fLZrFXJWfH1uwcTILfQvxJDtwtk9w-nMfZ8-3N0_z-2LxePcwv14UjaBqLHSpoG7rqnasqaBtnADOdIUAFUwwaalirq1q1kpbEeqEcrLm2jIOFQKOH2cXky8u9L6BNJqhSw30ODqETTJMUKaVZJwh9fwPdRU20eN0hpUCP0rhQRabWE0MKUVwZh27wcatocR8R2CmCAxGYHYRGI0iPokSkv0S4q_1P6ovmSKK9A</recordid><startdate>20210601</startdate><enddate>20210601</enddate><creator>Matsuda, Yasuhiro</creator><creator>Masuda, Masaharu</creator><creator>Asai, Mitsutoshi</creator><creator>Iida, Osamu</creator><creator>Okamoto, Shin</creator><creator>Ishihara, Takayuki</creator><creator>Nanto, Kiyonori</creator><creator>Kanda, Takashi</creator><creator>Tsujimura, Takuya</creator><creator>Okuno, Shota</creator><creator>Hata, Yosuke</creator><creator>Uematsu, Hiroyuki</creator><creator>Mano, Toshiaki</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5566-466X</orcidid></search><sort><creationdate>20210601</creationdate><title>Comparison of prognosis and safety of pacemaker implantation in patients aged less than or 85 years and older</title><author>Matsuda, Yasuhiro ; Masuda, Masaharu ; Asai, Mitsutoshi ; Iida, Osamu ; Okamoto, Shin ; Ishihara, Takayuki ; Nanto, Kiyonori ; Kanda, Takashi ; Tsujimura, Takuya ; Okuno, Shota ; Hata, Yosuke ; Uematsu, Hiroyuki ; Mano, Toshiaki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c418t-958ebdb6bf2c6edcf4e3296b6b142427a182fd6b2d7a601f48f7b39a23e6a60f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Bradycardia</topic><topic>C-reactive protein</topic><topic>Cardiology</topic><topic>Complications</topic><topic>Confidence intervals</topic><topic>Death</topic><topic>Implantation</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Mortality</topic><topic>Multivariate analysis</topic><topic>Pacemakers</topic><topic>Prognosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Matsuda, Yasuhiro</creatorcontrib><creatorcontrib>Masuda, Masaharu</creatorcontrib><creatorcontrib>Asai, Mitsutoshi</creatorcontrib><creatorcontrib>Iida, Osamu</creatorcontrib><creatorcontrib>Okamoto, Shin</creatorcontrib><creatorcontrib>Ishihara, Takayuki</creatorcontrib><creatorcontrib>Nanto, Kiyonori</creatorcontrib><creatorcontrib>Kanda, Takashi</creatorcontrib><creatorcontrib>Tsujimura, Takuya</creatorcontrib><creatorcontrib>Okuno, Shota</creatorcontrib><creatorcontrib>Hata, Yosuke</creatorcontrib><creatorcontrib>Uematsu, Hiroyuki</creatorcontrib><creatorcontrib>Mano, Toshiaki</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of interventional cardiac electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Matsuda, Yasuhiro</au><au>Masuda, Masaharu</au><au>Asai, Mitsutoshi</au><au>Iida, Osamu</au><au>Okamoto, Shin</au><au>Ishihara, Takayuki</au><au>Nanto, Kiyonori</au><au>Kanda, Takashi</au><au>Tsujimura, Takuya</au><au>Okuno, Shota</au><au>Hata, Yosuke</au><au>Uematsu, Hiroyuki</au><au>Mano, Toshiaki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of prognosis and safety of pacemaker implantation in patients aged less than or 85 years and older</atitle><jtitle>Journal of interventional cardiac electrophysiology</jtitle><stitle>J Interv Card Electrophysiol</stitle><date>2021-06-01</date><risdate>2021</risdate><volume>61</volume><issue>1</issue><spage>171</spage><epage>179</epage><pages>171-179</pages><issn>1383-875X</issn><eissn>1572-8595</eissn><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.</abstract><cop>New York</cop><pub>Springer US</pub><doi>10.1007/s10840-020-00797-9</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-5566-466X</orcidid></addata></record> |
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| ispartof | Journal of interventional cardiac electrophysiology, 2021-06, Vol.61 (1), p.171-179 |
| issn | 1383-875X 1572-8595 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2412987232 |
| source | SpringerLink Journals - AutoHoldings |
| subjects | Bradycardia C-reactive protein Cardiology Complications Confidence intervals Death Implantation Medicine Medicine & Public Health Mortality Multivariate analysis Pacemakers Prognosis |
| title | Comparison of prognosis and safety of pacemaker implantation in patients aged less than or 85 years and older |
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