Longevity of dual chamber pacemakers: device and patient related determinants

In 382 patients with three different dual chamber pulse generators, the median time interval to battery depletion was 98.3 months. Cox regression analysis revealed the following variables as significant predictors of battery longevity: programmed pacing rate, energy of the stimulation output, mode of stimulation (i.e., proportion of paced cycles in one or two chambers), battery capacity, and internal sensing current of the pacemaker. Although 27% of all patients died before the service life of the pacemaker was over and despite a rate of premature reoperations of 8.6%, the majority of pacemaker patients (55%) fully used the expected battery life span of the pulse generator. Patients who died before the pacemaker had reached its end of service were significantly older at implantation than patients who survived until pacemaker replacement. The vast majority (92%) of patients received another dual chamber pulse generator when replacement was required. These data underline the need for long-lasting dual chamber devices.