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    Pacemaker Study Stopped for Safety

    Patients with Implanted Defibrillators Should Have Older-Style Pacemaker


    One year after implantation, overall almost 84% of patients on the backup system survived and hospitalization from heart failure compared with only 74% of patients on the newer dual-chamber pacemaker.

    Heart failure hospitalizations occurred more frequently in those patients who had the dual-chamber pacemaker with almost 23% at one year having been hospitalized for heart failure versus 13% in the group who had the older backup-type pacemaker.

    The findings suggest that patients who need defibrillators might be better off with an older version of the device -- a single-chamber, backup pacemaker. The older model is much cheaper, costing anywhere from $2,000 to $9,000 less than the dual-chamber version. But Wilkoff says it is not yet clear whether the newer version offers other advantages to patients.

    American Heart Association president Robert O. Bonow, MD, tells WebMD that the new findings will surprise a lot of physicians who believed that dual-chamber, pacing was better for all patients.

    "This is reminiscent of the study that came out earlier this week showing that good, old, cheap diuretics may be just as good or better than the newer more expensive medications (for lowering blood pressure)," he says. "In this case, the simpler pacing method, which is easier to maintain and cheaper, may also be just as good or better."

    Bonow agrees that patients with defibrillators need to talk to their physicians, and have their devices reprogrammed, if needed.

    "I'm not saying they need to rush out and see their doctor tomorrow," he says. "But they should definitely discuss it at their next evaluation."

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