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• W2012191944 abstract "Objective This study sought to estimate the economic implications of managing bradycardia due to sinoatrial node disease or atrioventricular block with dual compared to single-chamber ventricular pacemakers from an Italian government perspective. Dual-chamber pacemakers lower the risk of developing atrial fibrillation and pacemaker syndrome. Methods A discrete event simulation of a patient's course for 5 years following pacemaker implantation. Each patient may experience the following: complications, pacemaker syndrome, atrial fibrillation, stroke, or death. Risk functions were based on published data from the Canadian Trial of Physiologic Pacing and Mode Selection Trial in Sinus-Node Dysfunction. Identical patients were simulated after receiving a single or dual-chamber pacemaker. Quality-adjusted life-years (QALYs) and direct medical costs were estimated (2004 Euros). Benefits and costs were discounted at 3%. Results The model predicts that implanting the dual-chamber device in 1000 patients will prevent 36 patients from developing atrial fibrillation, 168 from developing severe pacemaker syndrome, but will lead to 13 additional hospitalizations with complications over 5 years. Health benefits are achieved at an incremental cost of € 23 per patient, and 0.09 QALY, yielding an incremental cost–effectiveness ratio of € 260/QALY. Sensitivity analysis shows that device replacement rates due to pacemaker syndrome have the biggest impact on the final results. Conclusions In the long term, higher initial costs of the dual-chamber device may be offset by a reduction in costs associated with reoperations and atrial fibrillation." @default.
• W2012191944 created "2016-06-24" @default.
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• W2012191944 date "2008-01-01" @default.
• W2012191944 modified "2023-10-18" @default.
• W2012191944 title "Economic and health consequences of managing bradycardia with dual-chamber compared to single-chamber ventricular pacemakers in Italy" @default.
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• W2012191944 doi "https://doi.org/10.2459/jcm.0b013e328013cd28" @default.
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