The impact of pulse generator longevity on the long-term costs of cardiac pacing.

The long-term costs of cardiac pacing include the device costs, the procedural costs, the follow-up costs, and the replacement costs. At present, there is significant variability in the efficiencies of the integrated circuits and the total battery capacity among different pulse generators that will...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 19; no. 10; pp. 1459 - 1469
Autores principales: Gillis AM, Macquarrie DS, Wilson SL
Formato: research Journal Article
Publicado: Wiley-Blackwell Oct1996
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: The impact of pulse generator longevity on the long-term costs of cardiac pacing.
      aug:
        au:
          Gillis AM
          Macquarrie DS
          Wilson SL
      sug:
        subj:
          Pacemaker, Artificial Economics
          Aged
          Arrhythmia Economics
          Arrhythmia Etiology
          Arrhythmia Surgery
          Arrhythmia Therapy
          Female
          Male
          Power Sources Economics
          Survival Analysis
          Survival
          Time Factors
          United States
          Human
          Aged: 65+ years
          Female
          Male
      ab: The long-term costs of cardiac pacing include the device costs, the procedural costs, the follow-up costs, and the replacement costs. At present, there is significant variability in the efficiencies of the integrated circuits and the total battery capacity among different pulse generators that will influence replacement rates over time. Accordingly, we compared the influence of pulse generator longevity on the long-term costs of pacing. The longevity of pulse generators was calculated based on the electrical characteristics of the device and the percentage of time the patient is paced. Replacement rates of pulse generators were estimated for our patient population over a 20-year period, based on patient survival and pulse generator longevity. The costs of pacing over this 20-year follow-up period were then calculated. The longevity of DDDR devices presently implanted in the United States ranges from 8-14 years, assuming that patients are paced 50% of the time. Replacement rates in this population over a 20-year follow-up period were calculated to range from 0.34-0.66, and the total costs of pacing would range from $11,898-14,900 per patient. The longevity of SSIR devices ranges from 7-20 years, assuming that patients are paced 50% of the time. Replacement rates were calculated over the 20-year follow-up period to range from 0.20-0.84, and the total costs of VVIR pacing would range from $8,331-i 3,286. Based on the proportion of pulse generator models implanted in patients in the United States, the maximum cost differential to the health care system is approximately $424 million/year comparing the devices with the shortest and greatest longevities. Thus, pulse generator longevity may significantly influence the long-term costs of pacing. Patient survival and pulse generator system longevity should be considered when selecting the appropriate pacing system for the individual patient.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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