Physical activity and mortality in older patients with a pacemaker. Issue 2 (9th December 2019) - Goto, Toshihiko
Abstract : Aim: With increasing lifespans, patients requiring a pacemaker are older than they were in the past. Data regarding all‐cause mortality in older patients implanted with a pacemaker are scarce. As physical activity is associated with a decrease in all‐cause mortality, we investigated whether daily physical activity time, expressed as the activity rate determined by pacemakers, can predict all‐cause mortality in older patients (aged ≥75 years) with a pacemaker. Methods: We retrospectively investigated the baseline characteristics, echocardiographic indices, laboratory data and pacemaker parameters of 107 consecutive older patients with a newly implanted pacemaker at our hospital (age 83.8 ± 5.0 years; 54.2% men). The study end‐point was all‐cause mortality. Results: During the follow‐up period (mean 3.0 years), 21 cases of all‐cause death were reported. The area under the receiver operating characteristic curve for activity rate to predict all‐cause mortality was 0.82 (95% confidence interval 0.72–0.92, P < 0.001). An activity rate of 3.4% (50 min/day) had a sensitivity of 86.0% and a specificity of 66.7% for predicting all‐cause mortality. The survival rate was significantly higher among patients with an activity rate ≥3.4% than among those with an activity rate <3.4% (log–rank, P < 0.001). A multivariate Cox regression analysis identified low activity rates as a predictor of all‐cause mortality (hazard ratio 15.0, 95% confidence interval 4.29–52.6; P < 0.001). Conclusions: Low activity rates appear to be a strong predictor of all‐cause mortality in older patients with a pacemaker. Geriatr Gerontol Int 2020; 20: 106–111 .