Nowak Bernd, Misselwitz Björn
Cardiovascular Center Bethanien (CCB), Im Pruefling 23, D-60389 Frankfurt a.M., Germany.
Europace. 2009 Jan;11(1):75-9. doi: 10.1093/europace/eun293. Epub 2008 Nov 7.
The aim of the study was to evaluate the effects of increasing patients' age onto procedural parameters, especially complications, during primary pacemaker implantation, evaluating the database of the Institute of Quality Assurance Hessen in the federal state of Hessen, Germany.
The database of the obligatory external quality control program was evaluated retrospectively for the years 2003-2006. A total of 17 826 patients undergoing stationary primary pacemaker implantation have been registered in 72 centres. In single-chamber implants, the implant duration is shortest in non-agenarians. For dual-chamber implants, the implant duration shortens with increasing age. Thus, as well as fluoroscopy time is significantly shorter in the oldest patients. Atrial and ventricular pacing thresholds as well as R-wave amplitudes do not change with age. P-wave amplitudes showed a small but steady decline with increasing ages. Complications do not increase with advanced age.
In this large-scale real-life patient cohort of primary stationary pacemaker implantation, increasing age resulted only in reduced P-wave amplitudes. Higher age was not associated with an increased risk of complications. Thus, pacemaker implantations in the elderly can be performed with the same reliability as in younger patients.
本研究旨在通过评估德国黑森州质量保证研究所的数据库，探讨在初次植入起搏器过程中，患者年龄增加对手术参数尤其是并发症的影响。
对2003年至2006年强制性外部质量控制项目的数据库进行回顾性评估。共有17826例接受住院初次起搏器植入的患者在72个中心登记。在单腔植入中，非agenarians的植入时间最短。对于双腔植入，植入时间随着年龄的增加而缩短。因此，年龄最大的患者的透视时间也明显更短。心房和心室起搏阈值以及R波振幅不会随年龄变化。P波振幅随着年龄的增加呈现出小幅度但稳定的下降。并发症不会随着年龄的增长而增加。
在这个大规模的初次住院起搏器植入的真实患者队列中，年龄增加仅导致P波振幅降低。高龄与并发症风险增加无关。因此，老年患者的起搏器植入可以与年轻患者一样可靠地进行。
