Jose Antonio Lapuerta-Irigoyen, Santiago Herrero

The treatment of choice in symptomatic cases of patients with severe bradycardia remains the implantation of a pacemaker. 1, 2 In the Western countries, the increase in life expectancy, along with programs of universal medical assistance in the elderly has shown that implants of pacemakers are on the rise (32% implants in patients >80 year). 3 Also, the high economic cost, associated to the electrotherapy has given rise to a great controversy, including the optimal selection of the way of stimulation, strategy of implantation and clinical benefit of pacemakers usage in patients of >80 years.