Heart 1998;80:387-389 ( October )
Single chamber atrial pacing: an underused and cost-effective pacing modality in sinus node disease
The
Cardiothoracic Centre, Thomas Drive, Liverpool L14 3PE, UK
Correspondence to: Dr Clarke.
Accepted for publication 6 April 1998
Objective
To determine the safety and cost
effectiveness of single chamber atrial pacing in patients with sinus
node disease.
DesignRetrospective follow up study.
SettingTertiary referral centre.
Patients81 patients with single chamber atrial
pacemakers implanted between 1992 and 1996.
Main outcome measuresThe development of
high grade atrioventricular block resulting in a further pacemaker
procedure. The cost savings of changing our current pacing practice to
conform with British Pacing and Electrophysiology Group guidelines.
ResultsDuring the follow up period, four
patients (5.8%) required a further procedure to upgrade their atrial
pacemaker to a dual chamber system owing to the development of high
grade atrioventricular block. In 1995 and 1996, 343 pacemakers were
implanted in patients with sinus node disease; 19 (5.5%) received
single chamber atrial pacemakers and 271 (79%) dual chamber
pacemakers. If the current pacing practice was changed so that all
patients received single chamber atrial pacemakers, with revision for
symptomatic atrioventricular block, savings in excess of £206 000
would have been made in the two year period.
ConclusionsAtrial pacing in patients with
sinus node disease is underused. The need for patients to undergo
further procedures owing to the development of atrioventricular block
is small and significant cost savings could be made by changing
pacemaker practice.
© 1998 by Heart
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[Abstract] [Full Text] -
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(1998). AAI pacing for sick sinus syndrome: first choice on all counts. Heart
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