所属 医学部 医学科（東京女子医科大学病院） 職種 特任准教授
|発表タイトル||Clinical Features of Elderly Patients Implanted with a Leadless Pacemaker: Results from Two High Volume Institutes|
|発表者・共同発表者||◎柳下大悟, 庄田守男, 岡田綾子, 樋口諭, 矢崎恭一郎, 金井美和, 江島浩一郎, 萩原誠久|
|概要||*Poster Session (Japanese)31 Leadless Pacemaker
Background: Indications of leadless pacemaker (LP) in elderly patients may vary according to its potential benefits although LP is limited to VVI pacing.
Objective: The purpose of this study was to elucidate clinical features in elderly patients with LP.
Methods: Forty-seven consecutive patients who underwent LP implantation in two high-volume centers were enrolled. The patients were divided into elderly group (≥85 years, EG) and non-elderly group (<85 years, non-EG) to compare clinical and procedural characteristics.
Results:The mean age was 89.5±3.4 in EG (N=21), and 72.3±8.1 in non-EG (N=26). The LP indication for atrial fibrillation with bradycardia was significantly less in EG than NEG (29.2% vs 70.8%, P<0.05). EG had significantly smaller height (152.0±7.6cm vs 159.4±10.2cm, P<0.01), while body weight was similar. The prevalence of dementia was significantly higher in EG (73.3% vs 26.7%, P<0.05). The number of risk factors reported to be associated with cardiac
perforation/effusion was significantly more in EG compared to non-EG (3.3±1.2 vs 1.9±1.0, P<0.01). However, there were no significant differences in procedure time, number of deployment, and pacing data between two groups. Major complication was observed in 8 patients as follows; pericardial effusion due to temporary pacing wire in 1, high pacing threshold in 1, unsuccessful implantation in 1, and groin hematoma in 5 patients. There was no significant difference in the complication rate between two groups.
Conclusion: LP implantation procedure was safely performed in both groups although EG had more risk factors of cardiac perforation/effusion. Careful attention should be paid for the indication and the implantation procedure of LP in elderly patients.