Nicolas Clémenty1, Jérôme Fernandes2, Phuong Lien Carion3, Lucie de Léotoing4, Ludovic Lamarsalle4, Fanny Wilquin-Bequet3, Claudia Wolff5, Koen J P Verhees6, Emmanuelle Nicolle5, Jean-Claude Deharo7. 1. Centre Hospitalier Régional Universitaire de Tours, Université François Rabelais de Tours , Tours , France. 2. OC Santé, Centre Médical Odysseum , Montpellier , France. 3. Medtronic France , Boulogne-Billancourt , France. 4. HEVA , Lyon , France. 5. Medtronic International Trading Sàrl , Tolochenaz , Switzerland. 6. Medtronic, Bakken Research Center (BRC) , Maastricht , The Netherlands. 7. Department of Cardiology, Centre Hospitalier Universitaire (CHU), Hôpital de la Timone, Medical School of Marseille , Marseille , France.
Abstract
Aims: Novel leadless pacemakers (LPMs) may reduce complications and associated costs related to conventional pacemaker systems. This study sought to estimate the incidence and associated costs of traditional pacemaker complications, in those patients who were eligible for LPM implantation. Methods: A retrospective analysis was conducted on the French National Hospital Database (PMSI), including all patients implanted with a pacemaker in France in 2012, who could have alternatively received an LPM. Complication rates and their associated costs 3 years post-implantation were estimated from the perspective of the French social security system. Results: From a total of 65,553 patients, 11,770 (18%) met the inclusion criteria. Overall, 618 patients (5.3%) had a record of pacemaker complications during follow-up, of which 89% were related to the lead and pocket. Most common were pocket bleeding, lead- or generator-related mechanical complications, and pneumothorax. Overall, the mean cost of pacemaker complications per patient was €6,674 ± 3,867 at 3 years. Specifically, €7,143 ± 2,685 for pocket bleeding, €5,123 ± 2,676 for pneumothorax, and €6,020 ± 3,272 for mechanical complications. Conclusions: Major complications associated with the lead and pocket of conventional pacemaker systems are still common, and these represent a significant burden to healthcare systems as they generate substantial costs.
Aims: Novel leadless pacemakers (LPMs) may reduce complications and associated costs related to conventional pacemaker systems. This study sought to estimate the incidence and associated costs of traditional pacemaker complications, in those patients who were eligible for LPM implantation. Methods: A retrospective analysis was conducted on the French National Hospital Database (PMSI), including all patients implanted with a pacemaker in France in 2012, who could have alternatively received an LPM. Complication rates and their associated costs 3 years post-implantation were estimated from the perspective of the French social security system. Results: From a total of 65,553 patients, 11,770 (18%) met the inclusion criteria. Overall, 618 patients (5.3%) had a record of pacemaker complications during follow-up, of which 89% were related to the lead and pocket. Most common were pocket bleeding, lead- or generator-related mechanical complications, and pneumothorax. Overall, the mean cost of pacemaker complications per patient was €6,674 ± 3,867 at 3 years. Specifically, €7,143 ± 2,685 for pocket bleeding, €5,123 ± 2,676 for pneumothorax, and €6,020 ± 3,272 for mechanical complications. Conclusions: Major complications associated with the lead and pocket of conventional pacemaker systems are still common, and these represent a significant burden to healthcare systems as they generate substantial costs.
Authors: Vijayatubini Vijayarajan; Leonard Kritharides; David Brieger; Yeu-Yao Cheng; Vincent Chow; Austin Chin Chwan Ng Journal: PLoS One Date: 2022-08-10 Impact factor: 3.752