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Clinically guided pacemaker choice and setting: pacemaker expert programming study.

Matteo Ziacchi1, Pietro Palmisano2, Ernesto Ammendola3

  • 1Institute of Cardiology, University of Bologna, S. Orsola-Malpighi University Hospital, Bologna, Italy.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|October 15, 2016
PubMed
Summary
This summary is machine-generated.

A study of 1858 patients found that 35.7% received suboptimal pacemaker (PM) devices for their condition. Additionally, a quarter of appropriate PMs were not optimally programmed, highlighting issues in pacemaker selection and programming.

Keywords:
BradyarrhythmiasDevice settingPacemakerPermanent pacingRhythm disorder

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Area of Science:

  • Cardiology
  • Medical Devices
  • Clinical Research

Background:

  • Pacemaker (PM) selection and programming are crucial for managing cardiac rhythm disorders.
  • Real-world data on PM choice and setting appropriateness is essential for improving patient outcomes.

Purpose of the Study:

  • To evaluate pacemaker choice and setting in relation to patient clinical characteristics.
  • To identify factors contributing to inappropriate pacemaker selection and programming.

Main Methods:

  • A multicentre, observational, transversal study involving 1858 patients across 7 Italian cardiac arrhythmia centres.
  • Analysis of rhythm disorders at device implantation and characteristics of implanted devices.
  • Assessment of current rhythm disorders and device settings at enrolment for appropriateness.

Main Results:

  • 64.3% of patients received a pacemaker with features appropriate for their rhythm disorder.
  • Inappropriate PM choice was most often due to lack of intrinsic AV conduction algorithms in non-persistent AV block (38.1%).
  • Optimal PM setting was achieved in 76.2% of patients with appropriately chosen devices.

Conclusions:

  • A significant proportion of patients (35.7%) did not receive an optimal pacemaker for their specific rhythm disorder.
  • Approximately 25% of appropriately chosen pacemakers were not programmed according to patient clinical characteristics.
  • This 'real-world' registry highlights a need for improved pacemaker selection and programming practices.