Clinical Investigations: ElectrophysiologyHealth values before and after pacemaker implantation☆,☆☆,★
Section snippets
Study participants
The Pacemaker Selection in the Elderly (PASE)4 trial was a single-blind, randomized, 29-center controlled trial of ventricular pacing versus dual chamber pacing in 407 patients aged ≥65 years. The primary end point was health-related quality of life. To participate, patients had to be in sinus rhythm at the time of implantation and had to have bradycardia as the indication for a permanent pacemaker. All participants provided written informed consent before participation. Patients were excluded
Results
PASE enrolled 407 patients who were observed for an average of 550 days. The time-tradeoff questionnaire was completed by 398 patients at baseline, by 284 patients at 3 months, by 291 patients at 9 months, and by 250 patients at 18 months of follow-up.
Discussion
This study demonstrated that health values improve after pacemaker implantation and that that improvement is only partially explained with the improvement in other measurements of quality of life. The 2 main approaches to assessing health-related quality of life are descriptive health status and health utility measurement.12, 13 The health status evaluation describes the individual's well being and functioning in 1 or several domains such as health perception, physical functioning, mental
Acknowledgements
We thank Elaine Abrams, the telephone interviewer, without whose determined and careful efforts, these analyses would not have been possible, the PASE coordinators and investigators, and Mrs Lori Saint-Thomas, for her careful secretarial assistance.
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Cited by (26)
2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: Developed by the Task Force on Cardiac Pacing and Cardiac Resynchronization Therapy of the European Society of Cardiology (ESC), with the special contribution of the European Heart Rhythm Association (EHRA)
2022, Revista Espanola de CardiologiaLife expectancy after implantation of a first cardiac permanent pacemaker (1995-2008): A population-based study
2015, International Journal of CardiologyCitation Excerpt :This would account for the lower proportion of age-stratified deaths from cancer, stroke and dementia than observed at the national level, albeit on low numbers of patients. Although medical interventions become more complicated and expensive in patients with limited LE due to advanced age [8,18], the oldest patients, in particular, may benefit from improvements in mobility, cognitive function, and activities of daily living [20,21]. Increasing LE and longer follow-up, even for older patients, has been associated with relatively low costs [22], making advanced age alone no argument for not implanting a PPM if indicated.
Long term quality-of-life in patients with bradycardia pacemaker implantation
2013, International Journal of CardiologyCitation Excerpt :We observed no clear association between maintained AV-synchrony (AAI/DDD) and HRQoL. Initially small, cross-over studies reported better HRQoL when patients had DDD pacing compared to VVI pacing mode [25,31], however more detailed analysis from data of large clinical trials as MOST, CTOPP and PASE, showed no difference in HRQoL between pacing modes [5,32,33]. In addition, other observational studies found no difference in HRQoL between pacing modes [19,20,34].
Predictors of improved quality of life 1 year after pacemaker implantation
2008, American Heart JournalCitation Excerpt :The results of these questions can be summarized into 3 subscales: chest discomfort, dyspnoe at exertion, and arrhythmias, each ranging from 0 to 100, with lower scores representing a lower HRQoL. We a priori selected a total of 9 possible predictors of HRQoL 1 year after PM implantation based on the existing literature.3,5-7,20-22 These included the patients' sex, age, and presence of several comorbidities (total cardiac comorbidity, coronary pathology, heart failure, and diabetes) assessed at implantation and based on the data in the patients' file, the indication for PM implantation, the used PM chamber system (dual- vs single-chamber pacing), and the occurrence of an adverse event at PM implantation.
Global Cost-effectiveness of Cataract Surgery
2007, OphthalmologyThe relevance of health related quality of life in paced patients
2005, International Journal of Cardiology
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Supported by a grant from Intermedics, Inc.
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Reprint requests: Gervasio A. Lamas, MD, Mount Sinai Medical Center, 4300 Alton Rd, Suite 207A, Miami Beach, FL 33140.
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E-mail: [email protected]