{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T19:45:04Z","timestamp":1775072704834,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2018,9,22]],"date-time":"2018-09-22T00:00:00Z","timestamp":1537574400000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The rate of device replacement in pacemaker recipients has not been investigated in detail.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Current pacemakers with automatic management of atrial and ventricular pacing output provide sufficient longevity to minimize replacement rate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We considered a cohort of 542 pacemaker patients (age 78 \u00b1 9 years, 60% male, 71% de\u2010novo implants) and combined 1\u2010month projected device longevity with survival data and late complication rate in a 3\u2010state Markov model tested in several Monte Carlo computer simulations. Predetermined subgroups were: age &lt; or \u2265 70; gender; primary indication to cardiac pacing.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At the 1\u2010month follow\u2010up the reported projected device longevity was 153 \u00b1 45 months. With these values the proportion of patients expected to undergo a device replacement due to battery depletion was higher in patients aged &lt;70 (49.9%, range 32.1%\u201061.9%) than in age \u226570 (24.5%, range 19.9%\u201028.8%); in women (39.9%, range 30.8%\u201048.1%) than in men (32.0%, range 24.7%\u201037.5%); in sinus node dysfunction (41.5%, range 30.2%\u201053.0%) than in atrio\u2010ventricular block (33.5%, range 27.1\u201038.8%) or atrial fibrillation with bradycardia (27.9%, range 18.5%\u201037.0%). The expected replacement rate was inversely related to the assumed device longevity and depended on age class: a 50% increase in battery longevity implied a 5% reduction of replacement rates in patients aged \u226580.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>With current device technology 1\/4 of pacemaker recipients aged \u226570 are expected to receive a second device in their life. Replacement rate depends on age, gender, and primary indication owing to differences in patients' survival expectancy. Additional improvements in device service time may modestly impact expected replacement rates especially in patients \u226580 years.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.23003","type":"journal-article","created":{"date-parts":[[2018,6,23]],"date-time":"2018-06-23T07:24:39Z","timestamp":1529738679000},"page":"1185-1191","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Impact of pacemaker longevity on expected device replacement rates: Results from computer simulations based on a multicenter registry (ESSENTIAL)"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9820-4815","authenticated-orcid":false,"given":"Giuseppe","family":"Boriani","sequence":"first","affiliation":[{"name":"Cardiology Division, Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia, Policlinico di Modena  Modena Italy"},{"name":"Institute of Cardiology, S.Orsola University Hospital, University of Bologna  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5285-7140","authenticated-orcid":false,"given":"Matteo","family":"Bertini","sequence":"additional","affiliation":[{"name":"Arcispedale S. Anna\u2010Cona Universit\u00e0 di Ferrara  Ferrara Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Saporito","sequence":"additional","affiliation":[{"name":"Ospedale degli Infermi  Rimini Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppina","family":"Belotti","sequence":"additional","affiliation":[{"name":"Ospedale Treviglio\u2010Caravaggio  Treviglio Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1605-0059","authenticated-orcid":false,"given":"Fabio","family":"Quartieri","sequence":"additional","affiliation":[{"name":"Ospedale S. Maria Nuova, IRCCS  Reggio Emilia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Corrado","family":"Tomasi","sequence":"additional","affiliation":[{"name":"Ospedale S. Maria delle Croci  Ravenna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Pucci","sequence":"additional","affiliation":[{"name":"Ospedale di Carrara  Carrara Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulio","family":"Boggian","sequence":"additional","affiliation":[{"name":"Ospedale di Bentivoglio  Bentivoglio Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gian Franco","family":"Mazzocca","sequence":"additional","affiliation":[{"name":"Ospedale Civile  Cecina Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davide","family":"Giorgi","sequence":"additional","affiliation":[{"name":"Ospedale San Luca  Lucca Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Diotallevi","sequence":"additional","affiliation":[{"name":"Clinica Citt\u00e0 di Alessandria  Alessandria Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Biagio","family":"Sassone","sequence":"additional","affiliation":[{"name":"Ospedale di Bentivoglio  Bentivoglio Italy"},{"name":"Ospedale SS Annunziata Cento (FE)  Ferrara Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego","family":"Grassini","sequence":"additional","affiliation":[{"name":"Biotronik Italia spa  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessio","family":"Gargaro","sequence":"additional","affiliation":[{"name":"Biotronik Italia spa  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4590-8584","authenticated-orcid":false,"given":"Mauro","family":"Biffi","sequence":"additional","affiliation":[{"name":"Institute of Cardiology, S.Orsola University Hospital, University of Bologna  Bologna Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on the behalf of ESSENTIAL Investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,9,22]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.976076"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/eut133"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2010.02724.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2010.02915.x"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8159.2008.02243.x"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euw021"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ehj.2003.10.022"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2006.08.010"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1540-8167.2001.00134.x"},{"key":"e_1_2_6_11_1","first-page":"253","volume-title":"Applied Methods of Cost\u2010Effectiveness Analysis in Health Care","author":"Gray AM","year":"2011"},{"key":"e_1_2_6_12_1","unstructured":"Italian National Institute of Statistics. 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