PM for an 86 y,o?

Hi everyone,  I'm a 57 y.o male, received an implanted PM in February.  I'm as happy as can be with it.  I don't really think about it, I run, cycle and go about my day.  My mother is 86, she's been having some issues lately with tachy-brady.  The docs are still sorting out just why this is happening for Mom.  My question (really hers) is, is 86 too old for a PM?  She has had an angiogram, there are no blockages, she is relatively speaking, fairly fit, rides her stationary bike every morning, goes to a friend's house and shoots pool.  Lives on her own, takes care of herself and her apartment.  Thanks in advance for your wisdom.  John


9 Comments

PM

by Persephone - 2020-11-30 13:14:53

Hi BradyJohn - Good for you for advocating for your mom and for fully embracing your life with a PM.  While I cannot offer any specific input to your question about an 86 y.o. having a surgical procedure such as PM implant, I would think a primary related concern would be about any medication that she may be prescribed to try to otherwise treat her condition.  We all need to keep an eye on the type and mix of prescriptions we may be instructed to take, especially if we are otherwise feeling well to start with.  Best wishes to you both.

In my opinion, 86 is not too old

by Gemita - 2020-11-30 13:23:49

John,

No, 86 is not too old to get a pacemaker if your Mom enjoys good health and her doctors are happy to go ahead.  Of course the older we are, the longer healing may take and there may be a higher risk of complications.

The main difficulty is that while the pacemaker will help to prevent bradycardia, it cannot stop tachycardia, but of course with a pacemaker your Mom’s doctors can give her medication to control her high heart rates without pushing her heart rate down too low.  The pacemaker will then prevent it from dropping below the minimum set level.

Your Mom sounds very healthy for her age.  May I ask whether your Mom’s doctors have recommended a pacemaker?  I have Tachy/Brady syndrome too and they gave me the option to have a pulmonary vein isolation ablation, AV Node ablation or a pacemaker.  I chose the latter.  I am 72.  My hubby has a pacemaker and he got his at 80.  We are both doing well.

I think it is important that your Mom has a long chat with her EP to find out what a pacemaker can and cannot do for her.  A pacemaker will control Bradycardia, but not Tachycardia.  The latter is controlled by medication or an ablation.  I was told that the cut off point for me to have an ablation would be 80 yrs.  If you need any further help, please let me know.  Greetings to your Mom

age is irrelevant`

by Tracey_E - 2020-11-30 14:47:19

If her rate gets too slow, or they need to give her enough meds to slow the tachy that she would get too slow, then a pacer is appropriate. Age has nothing to do with it. I would venture to say that there are more 86 year olds with pacers than 57. 

Re doctors' recommendations

by BradyJohn - 2020-11-30 16:37:44

Thanks Persephone, Gemita and Tracey,

In reponse to your question Gemita, my mother's internist brought up the idea of a pacemaker.  We're waiting to speak with him again, soon.

Peace,

John

Good luck

by Gemita - 2020-11-30 16:53:12

John, yes if your Mom needs a pacemaker, then she needs a pacemaker at whatever age.  I just wanted to be sure you understood that a pacemaker cannot cure rhythm disturbances but it can help doctors to treat them safely if a pacemaker is in place.  

I am on minimal meds now because having a higher minimum heart rate has made all the difference.  It was the bradycardia and falling heart rates that were triggering my arrhythmias.

Good luck to you both

Never too old for a PM if it's indicated

by crustyg - 2020-11-30 17:38:33

When I qualified in 1980, there was a general, unspoken ageist attitude.  During first post-qualification medical job my consultant talked about an 80-something patient who had been referred for 'dizzy spells' and had one waiting in OPD.  Quick thinking nurse took an ECG which proved intermittent HB (no implantable Reveal devices then) and the patient was whizzed over the cardiologists who implanted a PM =>cured.  We were surprised and the consultant gently chided us for our out-of-date attitudes!  In 1980!

Skip forward some decades, and fit, mentally agile and nimble 90-somethings are no longer infrequent enough to cause comment.  So if a PM is needed, bring it on!

Re 'Good luck' and 'never too old...'

by BradyJohn - 2020-11-30 18:13:14

Gemita, as you describe, my own PM 'cleaned up a weak electrical system' and the rhythm disturbances I was experiencing.   I'm hopeful that could do the same for my mother.

Crustyg, lovely encouragement, thanks!

 

Bradycardia

by Gemita - 2020-12-01 05:02:32

Yes John, a pacemaker doesn't work for everyone but it certainly works for me in helping to control my arrhythmias.  My EP quite honestly told me he couldn't guarantee it would help control my arrhythmias but it was worth a try.  In any event, it would certainly enable him to give me higher doses of meds to control my heart rates without causing dangerous heart rate falls.  

I remember he explained in some detail that for some, there is clear evidence to show that falling heart rates may be the trigger for their rhythm disturbances and that an increase in the heart rate might help outpace their rhythm disturbances.  To be honest, I still get some really nasty arrhythmia episodes and may ultimately need an ablation but generally now their duration, frequency is lessened.  My symptoms therefore are better controlled and my quality of life much improved.

Bear in mind too with your Mom that bradycardia may only get worse and instability leading to falls at her age would be serious, so if they can keep her heart rate strong and prevent dizzy spells she will benefit anyway.  But let us hope she will also get some respite from her arrhythmias like we have.  I expect they will do all the necessary checks first to make sure they have not missed any obvious treatable causes for her present acute symptoms (like electrolytes, thyroid, infection, current medication). 

 

Too old?

by Gotrhythm - 2020-12-07 15:11:58

For what it's worth, my sisiter got a pacemaker when she was 88.

In my opinion, age alone shouldn't be the deciding factor. If your mon's healthy, still able to life independently, and she wants the pacemaker, then age alone is not a good reason not to get a pacemaker.

 

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