In elderly patients with sinus node dysfunction, pacing modes that preserve atrioventricular synchrony reduce atrial fibrillation and improve quality of life, though their benefit in atrioventricular block remains controversial.
Supports AV-synchrony preserving pacing in elderly sinus node dysfunction; leaves open optimal strategy in atrioventricular block.
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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Kusumoto et al. (2002) studied this question.
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