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 .
Complications of Dual Chamber Pacemaker Implantation in the Elderly
Pacemakers are frequently implanted , yet accurate prospect i ve data on implant complications are limited . Elderly patients may be at increased risk of implant complications and are increasingly being referred for pacemaker implantation . The purpose of the present analysis was to define the incidence and possible predictors of serious complications of dual chamber permanent pacemaker implantation  in the elderly . Therefore , we sought to prospect ively identify the incidence and predictors of pacemaker implant complications in a large multicenter trial involving patients receiving a dual chamber pacemaker .  The Pacemaker Selection in the Elderly ( PASE ) study was a prospect i ve trial design ed to evaluate quality of life in  dual chamber pacemaker recipients age 65 years or older r and omized to DDDR versus VVIR programming . In addition to being age 65 years or older , patients enrolled in this study were in normal sinus rhythm , and had st and ard indications for permanent pacemaker implantation . All patients received dual chamber pacemakers and were r and omized to DDDR versus VVIR pacing . Pacemaker implant complications were collected on st and ardized forms which were completed at pacemaker implantation and during follow-up appointments . In this study of 407 patients , there were 26 complications occurring in 25 patients ( 6.1 % ) . The most frequent complication was lead dislodgment which occurred in 9 patients . This was followed by pneumothorax ( 8 patients ) and cardiac perforations ( 4 patients ) . In 18 patients ( 4.4 % ) repeat surgical procedures ( including chest tubes ) were required . Complications were noted prior to discharge in only 18 patients . There were no significant predictors of overall complications . Pneumothorax was more frequent in patients ≤75 years old , and was observed only in patients with subclavian venous access . In conclusion , complications from pacemaker implantation in the elderly are seen in 6.1 % of patients and 4.4 % of patients require a repeat surgical procedure . Other than advanced age and lower weight predicting for pneumothorax , there are no significant clinical predictors of
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 .