Introduction: In Israel life expectancy at birth is 80.96 years and nonagenarians are a growing population.
We report trends in pacing and long term outcome in nonagenarians over a 20 years period in a single Center compared with those of younger patients.
Methods: We retrospectively reviewed all the patients who underwent their first pacemaker implantation from 1-1-.1991 to 31-12-.2010 in our Center and were followed through 31-11-2013.
Results: During the study period 1009 patients underwent first pacemaker implantation in our Center: 45 patients were older than 90 years (mean age 92.5 ± 2.6) (4,5%), 300 patients aged between 80 and 89 years ( 29.8%), 396 patients aged between 70 and 79 years (39.3%) and 266 patients were younger than 70 years (26.4%).
Battery replacement was performed in 2 patients in whom first implant was at age ≥ 90 years (4.4%) and in 231 patients aged < 90 years (24%) (p<0.01).
Syncope was the most common symptom leading to pacing, followed by dizziness and fatigue in all age groups; no significant difference of symptoms was found between patients age groups ( p= 0.2).
In patients aged ≥ 90 years AVB and AF with slow ventricular response were more frequent, while SSS and CSH were less frequent than in younger patients (p=0.03981). No significant difference of electrocardiographic indications for pacing were found between patients younger than 90 years.
Single chamber pacemakers were implanted with significant growing frequency, according to the older patients age (p= 0.0001). Neither the indication for pacemaker implantation nor pacing mode influenced survival.
Conclusions: Nonagenarians are a growing population. Symptoms leading to pacing in patients aged ≥90 years were similar to those of younger patients, but difference was found in the electrocardiographic indications. Single chamber pacemakers were significantly more implanted than dual chamber pacemakers.
