Dual pacemakers worth the cost, U.S. study finds

Pricey pacemakers that regulate the heart's upper and lower chambers separately are worth the extra cost because they help keep patients out of the hospital, U.S. researchers reported on Monday.

The fancier dual-chamber models cost about $3,000 more than single-chamber devices and do not help patients live any longer on average, but still save money over time, the government-funded study found.

"The dual-chamber devices significantly reduced the rates of atrial fibrillation and heart failure hospitalizations, which over the long term results in a highly favorable cost-effectiveness ratio," said Dr. David Cohen of Harvard Medical School in Boston, who led the study.

Atrial fibrillation is a type of irregular heartbeat that can cause stroke and heart failure.

Single-chamber or right-ventricular pacemakers help control one of the two ventricles, the heart's two lower pumping chambers. Dual-chamber devices also pace one of the atria - the smaller, upper chambers.

In the first four years after implant, the dual-chamber devices had a cost-effectiveness ratio of $53,000 per quality adjusted year of life gained, Cohen's team reported in the American Heart Association journal Circulation.

For the report, Cohen's team studied 2,010 patients for four years. About half got dual-chamber devices and half the single-chamber devices.

SOURCE: Circulation, January 3 online, 2005.