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 .
Health economic evaluation of single-lead atrial pacing vs. dual-chamber pacing in sick sinus syndrome.
AIMS The recent Danish Multicentre R and omized Trial on Single-Lead Atrial ( AAIR ) Pacing versus Dual-Chamber ( DDDR ) Pacing in Sick Sinus Syndrome ( DANPACE ) suggested DDDR pacing as st and ard care . However , previous findings supported the routine use of AAIR pacing . This study investigated the cost-effectiveness of DDDR pacing compared with AAIR pacing for sick sinus syndrome . METHODS AND RESULTS A decision-analytical model based on patient-level data from three r and omized trials was design ed from the Danish healthcare system 's perspective . The main outcomes were lifetime costs , quality -adjusted lifeyears ( QALYs ) , and net monetary benefit . Quality -adjusted lifeyears were calculated by utilizing community-based preferences . Costs were calculated by utilizing the extensive data on re source consumption , from the DANPACE trial . Data were pooled and adjusted for baseline differences . Dual-chamber pacing was shown to be cost-effective in all the analyses using a willingness-to-pay ( WTP ) threshold of £ 20,000/QALY , and most analyses using a WTP of £ 30,000/QALY . When pooling the data and adjusting for baseline differences , Monte Carlo simulations revealed a 51 - 71 % probability of DDDR pacing being cost-effective at a WTP of £ 20,000/QALY , and a 42 - 58 % probability at a WTP of £ 30,000/QALY . Dual-chamber pacing was most likely to be cost-effective among elderly patients with comorbidity . The expected value of perfect information was low and initiation of additional publicly funded Danish trials was discouraged . CONCLUSION Dual-chamber pacing is likely to be a cost-effective treatment for sick sinus syndrome patients
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 .