No statistically significant difference was found between the pacing modes for mortality , heart failure , stroke , chronic atrial fibrillation or quality of life .
However , the risk of developing heart failure may vary with age and device .
The risk of heart failure may have an impact on the decision to use dual-chamber or single-chamber atrial pacemakers .
Results from an analysis based on age ( > 75 years or ≤ 75 years ) and risk of heart failure indicate that dual-chamber pacemakers dominate single-chamber atrial pacemakers ( i.e. are less expensive and more effective ) in older patients , whereas dual-chamber pacemakers are dominated by ( i.e. more expensive and less effective ) single-chamber atrial pacemakers in younger patients .
In patients with SSS without evidence of impaired AV conduction , dual-chamber pacemakers appear to be cost-effective compared with single-chamber atrial pacemakers .
BACKGROUND Bradycardia [ resting heart rate below 60 beats per minute ( b.p.m . ) ]
can be caused by conditions affecting the natural pacemakers of the heart , such as sick sinus syndrome ( SSS ) and atrioventricular ( AV ) blocks .
People suffering from bradycardia may present with palpitations , exercise intolerance and fainting .
The only effective treatment for patients suffering from symptomatic bradycardia is implantation of a permanent pacemaker .
OBJECTIVE To appraise the clinical effectiveness and cost-effectiveness of dual-chamber pacemakers compared with single-chamber atrial pacemakers for treating symptomatic bradycardia in people with SSS and no evidence of AV block .
Incidence and predictors of in-hospital events after first implantation of pacemakers.
AIMS Despite an annual rise in the numbers of patients receiving their first pacemaker ( PM )  , the risks of the implantation procedure remains unclear . The purpose of this prospect i ve study is to estimate the incidence of in-hospital events after first PM implantation  and to determine the predictors of these events . METHODS AND RESULTS Patients with conventional pacing diagnosis were included in the Dutch multicentre FOLLOWPACE PM registry that prospect ively documented patients ' prognosis and quality of life , and PM events after first implantation . From these registry characteristics , implantation data and in-hospital findings were analysed as potential predictors for events in a sample of 1198 patients . In 111 patients studied , at least one serious in-hospital event occurred ( incidence 10.1 % , 95%CI : 8.9 - 12.3 ) . Six variables , i.e. a lower body mass index , presence of heart failure in medical history , main indication for implantation , vena subclavia use for venous access , active atrial lead fixation , and the implantation of a dual chamber system , were found to be independent predictors of events after first PM implantation . The overall multivariable model yielded an ROC area of 0.65 ( 95%CI : 0.60 - 0.70 ) . CONCLUSION This large prospect i ve multicentre study identified six variables as independent predictors for serious in-hospital events after first implantation . This may assist the implanting cardiologist and surgeon to identify patients at higher risk , during and immediately after PM implantation
No statistically significant difference was found between the pacing modes for mortality , heart failure , stroke , chronic atrial fibrillation or quality of life .
However , the risk of developing heart failure may vary with age and device .
The risk of heart failure may have an impact on the decision to use dual-chamber or single-chamber atrial pacemakers .
Results from an analysis based on age ( > 75 years or ≤ 75 years ) and risk of heart failure indicate that dual-chamber pacemakers dominate single-chamber atrial pacemakers ( i.e. are less expensive and more effective ) in older patients , whereas dual-chamber pacemakers are dominated by ( i.e. more expensive and less effective ) single-chamber atrial pacemakers in younger patients .
In patients with SSS without evidence of impaired AV conduction , dual-chamber pacemakers appear to be cost-effective compared with single-chamber atrial pacemakers .
BACKGROUND Bradycardia [ resting heart rate below 60 beats per minute ( b.p.m . ) ]
can be caused by conditions affecting the natural pacemakers of the heart , such as sick sinus syndrome ( SSS ) and atrioventricular ( AV ) blocks .
People suffering from bradycardia may present with palpitations , exercise intolerance and fainting .
The only effective treatment for patients suffering from symptomatic bradycardia is implantation of a permanent pacemaker .
OBJECTIVE To appraise the clinical effectiveness and cost-effectiveness of dual-chamber pacemakers compared with single-chamber atrial pacemakers for treating symptomatic bradycardia in people with SSS and no evidence of AV block .