Key result
Nonagenarians undergoing leadless pacemaker insertion had a significantly lower in-hospital mortality rate (3.0% vs. 5.1%, aOR 0.696) compared to younger patients, likely reflecting conservative patient selection and survivorship bias.
Why the study?
Is leadless pacemaker insertion safe in nonagenarians?
Cohort (n=26,084)
Yes
Is leadless pacemaker insertion safe in nonagenarians?
Odds Ratio: 0.696 (95% CI 0.515–0.942)
Absolute Event Rate: 3% vs 5.1%
p-value: p=0.018
Leadless pacemaker insertion appears safe in nonagenarians, though outcomes may be influenced by survivorship bias.
LPM insertion may be safe in nonagenarians; hypothesis-generating due to survivorship bias and unmeasured confounders.
= .1). Our study demonstrates that LPM insertion could be safe in the very elderly population. However, our study likely demonstrates survivorship bias, as patients in the nonagenarian group had fewer overall comorbidities. Despite adjustment for known comorbidities, there remain confounders that are difficult to account for. Age itself does not seem to be a risk factor for worse outcomes in this population.
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Gill et al. (2025) conducted a cohort in Bradyarrhythmias requiring leadless pacemaker (n=26,084). Age ≥90 years vs. Age <90 years was evaluated on In-hospital mortality (aOR 0.696, 95% CI 0.515-0.942, p=0.018). Nonagenarians undergoing leadless pacemaker insertion had a significantly lower in-hospital mortality rate (3.0% vs. 5.1%, aOR 0.696) compared to younger patients, likely reflecting conservative patient selection and survivorship bias.
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