Geriatric issues in patients with or being considered for implanted cardiac rhythm devices: a case-based review

摘要

Virtually all cardiovascular diseases including arrhythmias, valve disease, coronary artery disease and heart failure (HF) are increasingly common with advancing age.[1] Age and disease-related changes in the heart including fibrosis in the atrial and ventricular myocardium and conduction system, scar tissue from myocardial infarction or other cardiomyopathic processes, increased inflammatory cytokines and changes to ion channels are just some of the factors that predispose older adults to arrhythmias.[2] These factors make many older adults potential candidates for cardiac implanted electronic devices (CIEDs). This paper presents several common scenarios regarding older adults with cardiac disorders who already have (or may be considered for) CIEDs and reviews the cardiac, electrophysiologic and geriatric issues that should be addressed in these situations.