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.
EAGLE KA, MULLEY AG, SINGER DE, et al. Single-Chamber and Dual-Chamber Cardiac Pacemakers: A Formal Cost Comparison. Ann Intern Med. 1986;105:264–271. doi: https://doi.org/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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