AAI pacing for elderly patients with sick sinus syndrome - A rational option?

The number of elderly patients with sick sinus syndrome who are candidates for atrial based pacing is increasing. However, the safety of AAI pacing in elderly population is not clear especially with respect to early and late complications. The aim of our study was to assess the safety, short and long-term complications of single chamber atrial pacing in the group of 141 consecutive patients (among them 37 patients aged more than 75 years) with sick sinus syndrome undergoing AAI pacemaker implantation. We found that complications from single chamber atrial pacing in the elderly are not infrequent. Progression to clinically significant a-v block or chronic atrial fibrillation although uncommon, is more frequently observed in elderly patients. Elderly patients more often required repeat surgical procedures. We concluded that careful selection of candidates for AAI pacing, especially among the elderly population, is essential.