Literature DB >> 11161919

Cost-effectiveness of dual-chamber pacemaker therapy: does single lead VDD pacing reduce treatment costs of atrioventricular block?

U K Wiegand1, J Potratz, F Bode, R Schreiber, H Bonnemeier, W Peters, H A Katus.   

Abstract

AIMS: Implantation of single-lead VDD pacemakers is an established alternative to DDD pacing in patients with atrioventricular block. This study compares the long-term costs of both systems. METHODS AND
RESULTS: Three hundred and sixty patients with atrioventricular block received VDD or DDD pacemakers in alternating order. Primary costs of implantation included: devices, leads and operation material, surgeons, nurses, medical technicians, and hospitalization. The mean cost of an uncomplicated DDD pacemaker implantation was defined as 1000 virtual cost-units (CU). Costs of pacemaker related complications or re-operations as well as upgrades from VDD to DDD devices were considered secondary costs and assessed during a mean follow-up period of 42+/-15 months. Pacing efficacy was assessed by event-free survival with maintained atrioventricular synchronized pacing mode. Costs of pacemaker devices were not different (639+/-26 CU in VDD vs 641+/-32 CU in DDD, ns). However, due to lower costs of lead hardware (102+/-10 CU in VDD vs 133+/-14 CU in DDD, P<0.001) and shorter implantation procedures (44.3+/-5.1 min vs 74.4+/-13.5 min, P<0.001), costs of an uncomplicated implantation were 8.9% lower in the VDD group (911+/-35 CU vs 1000+/-39 CU, P<0.001). A smaller complication rate in the VDD group led to a 16.1% reduction of secondary costs (26+/-17 CU year(-1)vs 31+/- 25 CU year(-1), P=0.024). Event-free survival did not differ between groups (83.4% in VDD vs 84.9% in DDD, ns).
CONCLUSION: Use of single-lead VDD pacemakers achieves significant reduction of implantation and follow-up costs without loss of therapeutic efficacy compared to conventional DDD systems. Copyright 2001 The European Society of Cardiology.

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Year:  2001        PMID: 11161919     DOI: 10.1053/euhj.2000.2126

Source DB:  PubMed          Journal:  Eur Heart J        ISSN: 0195-668X            Impact factor:   29.983


  9 in total

1.  Effects of AV-delay optimization on hemodynamic parameters in patients with VDD pacemakers.

Authors:  Konstantin A Krychtiuk; Michael Nürnberg; Romana Volker; Linda Pachinger; Rudolf Jarai; Matthias K Freynhofer; Johann Wojta; Kurt Huber; Thomas W Weiss
Journal:  Wien Klin Wochenschr       Date:  2014-03-21       Impact factor: 1.704

2.  Choosing pacemakers appropriately.

Authors:  G K Panicker; B Desai; Y Lokhandwala
Journal:  Heart Asia       Date:  2009-01-01

3.  Long term complications in single and dual chamber pacing are influenced by surgical experience and patient morbidity.

Authors:  F Eberhardt; F Bode; H Bonnemeier; F Boguschewski; M Schlei; W Peters; U K H Wiegand
Journal:  Heart       Date:  2005-04       Impact factor: 5.994

4.  Current concepts in pacing 2010-2011: the right and wrong way to pace.

Authors:  Simon Modi; Andrew Krahn; Raymond Yee
Journal:  Curr Treat Options Cardiovasc Med       Date:  2011-10

5.  [Efficiency potential in the pacemaker/implantable cardioverter defibrillator outpatient clinic].

Authors:  A Bauer; J Bauer; M Bauer; K Kelemen; F Voss; J Senges-Becker; S Weretka; H A Katus; R Becker
Journal:  Herzschrittmacherther Elektrophysiol       Date:  2006-03

6.  Long-term outcome of atrial synchronous mode pacing in patients with atrioventricular block using a single lead.

Authors:  Miry Blich; Mahmoud Suleiman; Tawfiq Zeidan Shwiri; Ibrahim Marai; Monther Boulos; Shlomo Amikam
Journal:  Clin Cardiol       Date:  2010-01       Impact factor: 2.882

7.  Long-term outcome in patients receiving permanent pacemaker implantation for atrioventricular block: Comparison of VDD and DDD pacing.

Authors:  Jo-Nan Liao; Tze-Fan Chao; Ta-Chuan Tuan; Chi-Woon Kong; Shih-Ann Chen
Journal:  Medicine (Baltimore)       Date:  2016-08       Impact factor: 1.889

8.  Cost-utility of surgical sutureless bioprostheses vs TAVI in aortic valve replacement for patients at intermediate and high surgical risk.

Authors:  Massimiliano Povero; Antonio Miceli; Lorenzo Pradelli; Matteo Ferrarini; Matteo Pinciroli; Mattia Glauber
Journal:  Clinicoecon Outcomes Res       Date:  2018-11-08

9.  Comparative Study of Electrical Stimulation of the Heart with VDD and DDD Pacemakers as to the Evolution to Atrial Fibrillation.

Authors:  Nelson Leonardo Kerdahi Leite de Campos; Rubens Ramos de Andrade; Marcello Laneza Fellicio; Antônio Sergio Martins; André Monti Garzesi; Leonardo Rufino Garcia; Tassya Bueno Takeda
Journal:  Braz J Cardiovasc Surg       Date:  2017 Sep-Oct
  9 in total

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