KlM A. EAGLE, M.D.; ALBERT G. MULLEY, M.D.; DANIEL E. SINGER, M.D.; DAVID SCHOENFELD, Ph.D.; J. WARREN HARTHORNE, M.D.; GEORGE E. THIBAULT, M.D.
Dual-chamber pacemakers, more sophisticated and costly than single-chamber pacemakers, are being used with increasing frequency, often with unclear indications. Proponents of dual-chamber devices have focused on initial differences in cost without considering additional induced costs. We examined the incremental cost of dual versus single-chamber pacemakers over the expected lifetime of a pacemaker recipient. In addition to initial costs, we included the costs of pacemaker malfunction, reimplantation, generator replacement, and follow-up. Expected differences in cumulative costs per patient were calculated over a 12-year period. Dual-chamber pacing is $2500 more costly at implantation. The difference in cumulative cost increases to $5100 by year 12, reflecting shorter functional life for dual-chamber pacemaker generators and increased cost of follow-up. The incremental cost of dual-chamber pacemaking is neither short-term nor trivial. Dual-chamber pacemakers should be reserved for those who clearly benefit from its advanced technology.
KlM A. EAGLE, ALBERT G. MULLEY, DANIEL E. SINGER, DAVID SCHOENFELD, J. WARREN HARTHORNE, GEORGE E. THIBAULT. Single-Chamber and Dual-Chamber Cardiac Pacemakers: A Formal Cost Comparison. Ann Intern Med. 1986;105:264–271. doi: 10.7326/0003-4819-105-2-264
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Published: Ann Intern Med. 1986;105(2):264-271.
Cardiology, Rhythm Disorders and Devices.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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