Long-term survival after pacemaker implantation for heart block in patients ≥65 years

Win Kuang Shen, Stephen C. Hammill, David L. Hayes, Douglas L. Packer, Kent R. Bailey, David J. Ballard, Bernard J. Gersh

Research output: Contribution to journalArticle

39 Scopus citations

Abstract

Permanent pacing can prevent recurrent symptoms and reduce mortality in elderly patients with symptomatic high-degree atrioventricular (AV) block. However, long-term survival with respect to comparable control subjects has not been well defined. In our study, relative long-term survival and prognostic predictors after permanent pacemaker implantation for symptomatic high-degree AV block were assessed among all residents of Olmsted County, Minnesota, who were ≥65 years old. Of the 154 patients, 77 were men and 77 were women (mean age 80 ± 7 years). Follow-up was 0.1 to 19.8 years (mean 4.2 ± 2.8). Sixty-nine patients had isolated AV block and 85 had coexisting heart disease. Observed survival at 1, 3, 5, and 10 years was 85%, 68%, 52%, 21%, and 72%, 50%, 31%, 11% for patients with isolated AV block and patients with coexisting heart disease, respectively (p = 0.006). Observed survival in patients 65 to 79 years old with isolated AV block was comparable to age- and sex-matched cohorts (p = 0.53), but in patients aged ≥80 years, it was less than that for control subjects (p = 0.014). In patients with coexisting heart disease, observed survival was less than that for control subjects in patients 65 to 79 years old (p < 0.001) and ≥80 years p < 0.001). Multivariate analysis identified congestive heart failure, chronic obstructive pulmonary disease, age, syncope, insulin-dependent diabetes mellitus, and male gender as independent predictors of increased mortality.

Original languageEnglish (US)
Pages (from-to)560-564
Number of pages5
JournalThe American journal of cardiology
Volume74
Issue number6
DOIs
StatePublished - Sep 15 1994

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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