Your question is a good one, and complicated. I encourage you and your grandfather to speak with his cardiologist
, who is the doctor
that would implant the pacemaker, and his primary care doctor
, if your grandfather has a longstanding relationship with his primary care doctor. These two physicians can explain the medical indications for a pacemaker, and the consequences of having one in place.
A pacemaker is an electrical device that has two parts: a "box" that is implanted under the skin on the chest and that is programmed to provide a certain minimum heart rate, and a wire that goes to the heart muscle to provide a little surge of electricity if the heart is going slower than the set minimum heart rate. The patient cannot feel these little surges of electricity.
Generally, a pacemaker is recommended for certain types of bradycardia, or slow heart rate, or for certain heart rhythms called "heart block." There are three types of heart block, some of which are harmless and do not need a pacemaker, and others that can result in a poorly contractile heart and thus need a pacemaker for backup.
I recommend your grandfather consider his overall health when deciding whether to get a pacemaker at age 90. For some patients in their 90s who have many medical problems, having a pacemaker would extend their life expectancy a number of years, keeping them alive through hospitalizations for complications from their other medical problems, which may not be something they desire. Other patients in their 90s may have a strong desire to live as long as possible, and a pacemaker may be in line with their goals of care. I encourage you to speak with the cardiologist and primary care doctor to address these issues for your grandfather's particular situation.