What question did this study set out to answer?

To evaluate the real-world performance, failure modes, and actual versus projected longevity of lithium-powered single-chamber and dual-chamber cardiac pacemakers using remote monitoring.

May 1, 1986Pacing and Clinical Electrophysiology

Transtelephonic Monitoring of 25,919 Implanted Pacemakers

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Why the study?

What is the actual longevity and malfunction rate of single versus dual chamber lithium-powered pacemakers monitored transtelephonically?

Key Points

To evaluate the real-world performance, failure modes, and actual versus projected longevity of lithium-powered single-chamber and dual-chamber cardiac pacemakers using remote monitoring.
Followed 25,919 lithium-powered pacing systems (23,517 single-chamber and 2,402 dual-chamber generators) in 21,750 patients using a transtelephonic monitoring database.
Analyzed cumulative follow-up durations (719,173 months for single-chamber; 38,718 months for dual-chamber), explant timing, causes of failure, and physician-action incidence rates across 28 pacemaker series from 10 manufacturers.
Mean time to explant for generator malfunctions was 42 months in single-chamber pacemakers versus 31.9 months in dual-chamber pacemakers, with battery exhaustion causing 37% and 49% of explants, respectively.
Single-chamber pacemakers achieved an average of only 63% of their manufacturer-projected longevity across 28 evaluated series.
Dual-chamber pacemakers showed an 8% problem incidence rate within the first 3 months jumping to 16% by month 28, compared to single-chamber units which reached a 4% incidence rate at 48 months.

Structured PICO

What is the actual longevity and malfunction rate of single versus dual chamber lithium-powered pacemakers monitored transtelephonically?

Population

21,750 patients with 25,919 lithium-powered pacing systems (23,517 single and 2,402 dual chambered pacemaker generators)

Intervention

Transtelephonic monitoring of lithium-powered pacemakers

Comparator

Single chamber vs. dual chamber pacemakers

Outcome

Pacemaker longevity, time to explant, and incidence of pacing system malfunctionssafety

The actual longevity of lithium-powered pacemakers, particularly dual-chamber units, is significantly lower than manufacturer projections, underscoring the necessity of long-term transtelephonic monitoring.

Discussion

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Implication

Shorter-than-projected longevity in both single- and dual-chamber pacemakers; leaves open optimal device selection and monitoring strategies pending prospective data.

Cite This Study

Dreifus et al. (1986) studied this question.

synapsesocial.com/papers/6a843ead22c36ed33af798c2 https://doi.org/10.1111/j.1540-8159.1986.tb04491.x

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Implication

Shorter-than-projected longevity in both single- and dual-chamber pacemakers; leaves open optimal device selection and monitoring strategies pending prospective data.

Transtelephonic Monitoring of 25,919 Implanted Pacemakers

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Transtelephonic Monitoring of 25,919 Implanted Pacemakers

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider