Preferences of Patients and Cardiologists Regarding Pacemaker Characteristics in Spain: A Discrete Choice Experiment

A better understanding of the preferences of patients and cardiologists for pacemaker characteristics is essential for advancing patient-centered care. We therefore aimed to identify and quantify the preference that patients and cardiologists assign to specific characteristics.

We conducted an observational, cross-sectional, descriptive study based on a discrete choice experiment (DCE). The design was informed by a literature review, a patient focus group, and a scientific committee.

A total of 42 patients (66.7% male, mean [SD] age 64.2 [12.1] years) and 42 cardiologists (64.3% male, mean age 47.3 [9.3] years) participated in the study. For both patients (P) and cardiologists (C), the most important characteristics of pacemakers (higher relative importance, RI) are MRI compatibility (P: 28.1%; C: 25.1%) and battery longevity (P: 22.6%; C: 23.8%). The type of follow-up is more highly valued by cardiologists than by patients (P: 10.2%; C: 21.1%), whereas pacemaker size is prioritized by patients (P: 19.1%; C: 7.7%). From the cardiologists' perspective, safety (12-month post-implantation infection rate: 19.39%) and technical aspects such as conduction system pacing (CSP) (15.14%), algorithms for minimizing unnecessary right ventricular stimulation (9.43%), and programming modes (9.11%) are also important decision drivers.

MRI compatibility and battery longevity are key factors for both patients and cardiologists in decision-making. Patients also prioritize generator size and replacement processes, while cardiologists additionally focus on safety (infection rates) and technical aspects (CSP and algorithms to reduce unnecessary right ventricular stimulation).