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Variability in Pacemaker Battery Estimates and Performance
Benjamin A Steinberg1,2,3,4, Riley Gillette2, Michael Torre4
1Department of Medicine, Denver Health Medical Center, Denver, Colorado, USA.
Background:
Permanent pacemaker (PPM) battery longevity impacts downstream procedures, patient outcomes, and healthcare costs.
Objectives:
To measure and predict PPM battery longevity in routine, clinical practice.
Methods:
We analyzed a nationwide, multicenter, remote monitoring dataset (PaceMate) to evaluate PPM battery longevity from 2007 to 2023. Multivariable models identified factors associated with replacement interval (RI) across device types and manufacturers. We also compared observed versus expected battery longevity and assessed differences between newer and older generation pacemakers.
Results:
We included 58,395 devices from 47 sites: 5803 single-chamber transvenous, 1637 single-chamber leadless, 45,293 dual-chamber transvenous, 1759 RV/LV-only CRT pacemakers, and 3903 full CRT-P systems (1888 reaching RI). Median observed battery longevity for the 1493 dual chamber transvenous pacemakers that reached RI ranged from (103 months for BSX to 125 months for MDT and BIO), with similar trends after adjustment (p<0.001). There was variability in median battery longevity across manufacturers for other device types: 105-122 months for single-chamber transvenous, 61-96 months for RV/LV-only CRT pacemakers, and 77-93 months for full CRT-P systems. Compared with older generators, those implanted in 2022-23 demonstrated improved estimated battery longevity for Medtronic devices but decreased for Abbott (no significant change for Boston Scientific).
Conclusions:
Observed pacemaker battery longevity, based on nearly 2000 devices reaching ERI, varies substantially by manufacturer and device type, without consistent improvement for newer devices. Device-based estimates of remaining longevity show manufacturer-specific variability and are influenced by programming and utilization, highlighting the need for individualized expectations in clinical practice.
Condensed Abstract:
Permanent pacemaker (PPM) battery longevity is clinically impactful and not well described in routine, clinical practice. We quantified pacemaker battery performance in a nationwide, multicenter, remote monitoring dataset, including 58,395 devices. Pacemaker battery longevity varies by manufacturer and device type, without consistent improvement for newer devices. Manufacturer-specific accuracy of battery longevity estimates and differences in device programming and utilization highlight the need for individualized expectations in clinical practice.
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