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Pacemaker follow-up: are the latest guidelines in line with modern pacemaker practice?
Erik O Udo1, Norbert M van Hemel, Nicolaas P A Zuithoff
1Department of Cardiology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands. e.o.udo@umcutrecht.nl
Summary
Pacemaker follow-up frequency often exceeds current needs, with many visits showing no required action. This suggests reducing routine in-hospital visits and exploring remote monitoring options for efficiency.
Area of Science:
- Cardiology
- Biomedical Engineering
- Health Services Research
Background:
- Pacemaker (PM) follow-up (FU) guidelines lack precise definition.
- Routine in-hospital FU is standard practice for bradycardia indications.
Purpose of the Study:
- Describe long-term in-hospital PM FU practices.
- Evaluate FU compliance with existing guidelines.
- Assess the proportion of visits with an action (VWA).
Main Methods:
- Prospective, multicentre study (FOLLOWPACE) from 2003-2010.
- Analysis of 15,472 FU visits for 1517 patients with first PMs.
- Data collected in 23 Dutch hospitals.
Main Results:
- Median FU of 4.9 years; median interval between visits 180 days after the first year.
- Most patients had 2 FU/year; 22% had 1 FU/year, 18% had >3 FU/year.
- VWA decreased from 52% in the first year to 17% after 6 years; PM programming unchanged in most FU.
Conclusions:
- Pacemaker FU frequency is often excessive and not guideline-compliant.
- A significant portion of FU visits are redundant, particularly after the first year.
- Reducing in-hospital FU frequency or implementing remote FU is recommended.
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