Pacemaker implantation in the extreme elderly.

Introduction: There are scant data for pacemaker implant complications and readmission rates in the extreme elderly (age ≥80 years) despite their common use in this population.

Methods: This is a retrospective chart review of consecutive patients (n = 149, age ≥80 years) who underwent pacemaker implantation at a community hospital electrophysiology program from July 2008 through June 2010. Single-, dual-, and biventricular-chamber pacemakers and generator changes were included for analysis; cardioverter-defibrillator devices, temporary pacemakers, and loop recorders were excluded.

Distal balloon occlusion allows epicardial lead placement in a tortuous branch of the great cardiac vein.

Cardiac resynchronization therapy (CRT) is a well established treatment modality in heart failure. Using standard techniques, placement of the left ventricular (LV) lead is usually successful; however LV lead placement failure remains a clinical problem. In the present report, the standard over-the-wire technique was not successful due to absence of the necessary support to place the lead into a tortuous vein.