Pacing therapy in the elderly |
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Authors: | Kusumoto Fred M Phillips Robert Goldschlager Nora |
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Institution: | From the Electrophysiology and Pacing Service, Division of Cardiology, Department of Medicine, Lovelace Medical Center and Division of Cardiology, Department of Medicine, University of New Mexico, Albuquerque, NM;;and Division of Cardiology, Department of Medicine, University of California, San Francisco General Hospital, San Francisco, CA |
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Abstract: | Bradycardia due to sinus node dysfunction and atrioventricular block is more commonly observed in the elderly. Aging is associated with progressive fibrosis in both the sinus node and atrioventricular conduction system (AV node, His bundle, right and left bundles). In the absence of reversible causes implantation of a permanent pacemaker is often required in the patient with symptomatic bradycardia. For elderly patients with sinus node dysfunction, pacing modes that preserve atrioventricular synchrony are associated with a reduced incidence of atrial fibrillation and improved quality of life. For patients with atrioventricular block, the importance of preserving atrioventricular synchrony in the elderly is controversial and is currently being evaluated. |
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