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Background Historically, the majority of pulse generators implanted in the United States remain at the nominal programmed settings from the time of implant.
While these nominal settings typically allow a sufficient safety margin to prevent later loss of capture with potential chronic threshold rise, the pulse generator with significant use would not be expected to last longer than that predicted by the manufacturer.
However, improvements in lead technology have resulted in significantly lower chronic capture thresholds, which would permit lower programmable output settings while still allowing acceptable safety margins.
Such changes could result in a significant reduction in long-term battery drain and translate into longer generator life.
Methods and Results One hundred eighty consecutive patients undergoing implantation of permanent pacemakers at our institution were studied to determine the impact of reprogramming on pulse generator longevity and cost.
Of these patients, 122 completed 6 months of follow-up at our institution and had pulse generators implanted that were capable of measuring battery current.
We compared the estimated longevity based on battery current at nominal settings with that based on settings achieved in follow-up.
The final settings were determined by the patient's physician using standard safety margins.
The predicted longevity was 6.95±1.59 years at nominal implant settings and 1I. 16±2.71 years at final programmed settings (P<. 001). (...)
Mots-clés Pascal : Pacemaker, Programmation, Stimulus électrique, Analyse coût efficacité, Economie santé, Longévité, Etude longitudinale, Traitement, Homme, Traitement instrumental, Stimulation instrumentale
Mots-clés Pascal anglais : Pacemaker, Programming, Electrical stimulus, Cost efficiency analysis, Health economy, Longevity, Follow up study, Treatment, Human, Instrumentation therapy, Instrumental stimulation
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0013608
Code Inist : 002B26E. Création : 21/05/1997.