Audit of urgent pacing therapy in nonagenarian patients and their follow up over one year

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction and objectives The aging of the population in the world and particularly in developed countries is changing the panorama of patients who are treated both on the socio-demographic level and on the indications for the care of elderly subjects. Antibes is the sixth region in France with the most nonagenarians. A study had already been carried out in our center on the management of coronary emergencies in people over 90 years old and this time we are interested in the management of rhythmic emergencies in the latter with a focus on permanent cardiac stimulation in emergency. Methods This 5-year retrospective descriptive study runs from 2016 to 2020 and analyzes the records of 156 nonagenarians hospitalized in the intensive care unit and 1322 planned visits of patients over 90 years old to the electrophysiology unit. Results Nonagenarians represent 16.6% of patients admitted for cardiac arrhythmias requiring intensive and / or invasive management. 65% of patients hospitalized in cardiac critical care unit (CCU) benefited from the implantation of a pacemaker, with 13% of them presenting non-severe complications related to the procedure. 2% died in the CCU. After their hospital stay 60% came for follow-up at 3 months and only 19.6% at 1 year. Conclusion This study highlights the need to make invasive cardiology practitioners aware of the growing proportion of this geriatric subgroup of very old patients (>90). There were no serious complications limiting the eligibility of nonagenarians. It seems necessary to develop a close collaboration of cardio-geriatricians and telecardiology in this subset of frail patients.