ObjectiveTo estimate the safety and feasibility of permanent pacemaker implantation in patients over 80 years old. MethodsTotally 125 patients aged over 80 years (very old group) who underwent permanent pacemaker implantation in General Hospital of Shenyang Military Command from January 1997 to December 2007 were selected. Another 570 elderly patients aged 65 to 79 years (elderly group),who received similar procedures during the corresponding period,served as controls. The clinical data,success rate of the procedures,and perioperative complications incidence rate were compared between the two groups. ResultsThe concomitance of multiple heart diseases (except the indications of pacemaker implantation) and the combinations of non-heart diseases were more frequent in very old group than in elderly group. The success rate of the procedures was 100% in both two groups. In very old group,single-chamber pacemaker was used in 69 patients,dual-chamber pacemaker in 50 patients,three-chamber pacemaker in 4 patients,and dual-chamber pacemaker combined with ICD in 2 patients. The patients in very old group had poor tolerance to the procedures and high perioperative complications incidence rate. The manipulation-associated perioperative complications incidence rate was not significantly different between the two groups. All complications were alleviated following effective treatment. All patients survived till being discharged from hospital. ConclusionIt is possible to avoid and decrease perioperative complications by considering the clinical features of heart diseases and improving perioperative management in over 80 years old patients,therefore it is safe and feasible to perform pacemaker implantation in patients over 80 years.