TY  - JOUR
PY  - 2016//
TI  - Reduction of falls and fractures after permanent pacemaker implantation in elderly patients with sinus node dysfunction
JO  - Europace
A1  - Brenner, Roman
A1  - Ammann, Peter
A1  - Yoon, See-Il
A1  - Christen, Stefan
A1  - Hellermann, Jens
A1  - Girod, Grégoire
A1  - Knaus, Urs
A1  - Duru, Firat
A1  - Krasniqi, Nazmi
A1  - Ramsay, David
A1  - Sticherling, Christian
A1  - Lippuner, Kurt
A1  - Kühne, Michael
SP  - 1220
EP  - 1226
VL  - 19
IS  - 7
N2  - AIMS: Elderly patients with sinus node dysfunction (SND) are at increased risk of falls with possible injuries. However, the incidence of these adverse events and its reduction after permanent pacemaker (PPM) implantation are not known. <br><br>METHODS AND RESULTS: Eighty-seven patients (mean [SD] age 75.4 [8.3] years, 51% women) with SND and an indication for cardiac pacing were included and were examined by a standardized interview targeting fall history. The incidence and total number of falls, falls with injury, falls requiring treatment, and falls resulting in a fracture were assessed for the time period of 12 months before (retrospectively) and after PPM implantation (prospectively). Furthermore, symptoms such as syncope, dizziness, and dyspnea were evaluated before and after PPM implantation. The implantation of a PPM was associated with a reduced proportion of patients experiencing at least one fall by 71% (from 53 to 15%, P < 0.001) and a reduction of the absolute number of falls by 90% (from 127 to 13, P < 0.001) during the 12 months before vs. after PPM implant. Falls with injury (28 vs. 10%, P = 0.005), falls requiring medical attention (31 vs. 8%, P < 0.001), and falls leading to fracture (8 vs. 0%, P = 0.013) were similarly reduced. Notably, fewer patients had syncope (4 vs. 45%, P < 0.001) and dizziness after PPM implantation (12 vs. 45%, P < 0.001). <br><br>CONCLUSION: Falls, fall-related injuries, and fall-related fractures are frequent in SND patients. Permanent pacemaker implantation is associated with a significantly reduced risk of these adverse events, although no causal relationship could be established due to the study design.<br><br>Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.<p />  <p>Language: en</p>
LA  - en
SN  - 1099-5129
UR  - http://dx.doi.org/10.1093/europace/euw156
ID  - ref1
ER  -