Routine pacemaker control, and selective replacement of pulse generators. A cost/benefit analysis

Two hundred and fifty patients with permanent pacemaker have been followed up with routine pacemaker controls in a pacemaker clinic for a 21 months period 1/3-73 to 1/1-75. Ninety-five pulsegenerators were replaced. Sixty-two of the replacements were due to impending battery exhaustion, nine elective and 24 for other reasons. Signs discovered by the patients led to replacements in 21 cases for impending battery exhaustion and in 17 cases for other reasons. Forty-one replacements for impending battery exhaustion and 7 other replacements followed a scheduled visit to the pacemaker clinic. The selective replacement policy resulted in an average gain of pulsegenerator lifetime of 6.5 months, compared to a 24 minths elective replacement policy. Increased safety is obtained by routine control of pacemaker patients in a pacemaker clinic.