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Reasons for escalating pacemaker implants.

David Birnie1, Kathryn Williams, Ann Guo

  • 1University of Ottawa Heart Institute, Ottawa, Ontario, Canada. dbirnie@ottawaheart.ca

The American Journal of Cardiology
|June 21, 2006
PubMed
Summary
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Pacemaker implantation rates have risen significantly, primarily due to increased use for sinus node dysfunction (SND). This trend occurred despite unchanged U.S. pacing guidelines, suggesting a shift in clinical practice for SND management.

Area of Science:

  • Cardiology
  • Medical Device Technology
  • Public Health

Background:

  • Pacemaker implantation rates have steadily increased over 15 years in the U.S.
  • This rise has occurred without significant changes in national pacing guidelines.
  • The underlying reasons for this trend remain unclear.

Purpose of the Study:

  • To investigate the trends and reasons behind the increasing pacemaker implantation rates in the United States.
  • To analyze changes in implantation rates for specific cardiac conditions.
  • To assess the impact of major pacing trials on clinical practice.

Main Methods:

  • Utilized data from the National Hospital Discharge Survey.
  • Analyzed age-adjusted pacemaker implantation rates from 1990 to 2002.

Related Experiment Videos

  • Examined implantation trends for isolated sinus node dysfunction (SND) and other indications.

    • Main Results:

    • Age-adjusted implantation rates increased from 370 to 612 per million between 1990 and 2002.
    • The rise in implantation rates is mainly attributed to increased procedures for isolated sinus node dysfunction (SND), which rose by 102%.
    • Dual-chamber pacemaker implantation rates also showed a progressive increase, comprising 82.8% of initial implantations in 2002.

    Conclusions:

    • U.S. pacemaker implantation rates have progressively increased, largely driven by rising rates for sinus node dysfunction.
    • The increasing prevalence of SND appears to be the primary factor behind higher implantation rates for this condition.
    • Major randomized pacing trials have seemingly had no discernible impact on U.S. pacing practices during the study period.