{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T05:09:58Z","timestamp":1766380198612,"version":"3.48.0"},"reference-count":8,"publisher":"BMJ","issue":"6858","license":[{"start":{"date-parts":[[1992,10,10]],"date-time":"1992-10-10T00:00:00Z","timestamp":718675200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.bmj.com\/company\/legal-information\/terms-conditions\/legal-information\/tdm-licencepolicy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ"],"published-print":{"date-parts":[[1992,10,10]]},"abstract":"<jats:p>OBJECTIVE--To compare present pacing practice with the recommendations recently published by the British Pacing and Electrophysiology Group and to assess the increase in annual budget required to implement these recommendations in a regional cardiothoracic unit. DESIGN--Retrospective analysis of pacemaker implantation for 1991 with calculation of the costs required to implement the group's recommendations based on average 1991 costs of the types of pacing generators and electrode leads used. SETTING--Regional cardiothoracic unit for South West Thames Health Authority. PATIENTS--433 consecutive patients receiving permanent pacemaker generators: 76 (18%) with sinus node disease; 270 (62%) with atrioventricular block; 25 (6%) with both sinus node disease and atrioventricular block; 59 (14%) with chronic atrial fibrillation and atrioventricular block; and 3 (1%) with carotid sinus or malignant vasovagal syndromes. RESULTS--Only 102 (24%) patients received pacemaker generators recommended by the British Pacing and Electrophysiology Group; however, 355 (82%) patients were older than 65 years, and 264 (61%) were aged 75 or over. The cost of hardware for pacing was 462,885 pounds. Using generators as recommended would have cost 810,525 pounds for \"optimal\" systems (an increase of 75%) and 710,750 pounds for \"alternative\" systems (an increase of 54%). These increases would have been considerably reduced by limiting the use of sophisticated pacing to younger patients (aged under 75). Further savings could be made by using the least expensive pacing models available. CONCLUSIONS--Implementing these recommendations should reduce morbidity related to bradyarrhythmia but will lead to major increases in pacing costs. Age and patients' expected activity may be used to select simple pacing systems and thus to contain cost. More research is needed to determine which patient groups will benefit most from complex pacing systems.<\/jats:p>","DOI":"10.1136\/bmj.305.6858.861","type":"journal-article","created":{"date-parts":[[2009,3,30]],"date-time":"2009-03-30T08:16:37Z","timestamp":1238400997000},"page":"861-865","source":"Crossref","is-referenced-by-count":30,"title":["Cost implications of the British Pacing and Electrophysiology Group's recommendations for pacing."],"prefix":"10.1136","volume":"305","author":[{"given":"M. A.","family":"de Belder","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N. J.","family":"Linker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Jones","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. J.","family":"Camm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D. E.","family":"Ward","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[1992,10,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/0140-6736(92)90191-5","article-title":"Indications for pacing","volume":"339","author":"Ahsan, A.","year":"1992","unstructured":"Ahsan A. Indications for pacing. Lantcet 1992;339:62.","journal-title":"Lantcet"},{"key":"ref_2","first-page":"300","article-title":"Pacing for sinus node disease: prevalence and complications in the UK of different stimulation modes","volume":"11","author":"Ahsan, A.J.; Madden, S.; Rickards, A.F.","year":"1990","unstructured":"Ahsan AJ, Madden S, Rickards AF. Pacing for sinus node disease: prevalence and complications in the UK of different stimulation modes [abstract]. EairHearty 1990;11:300.","journal-title":"EairHearty"},{"key":"ref_3","first-page":"1237","article-title":"The sick sinus syndrome (SSS): prognosis as function of age, conduction defects and pacing mode","volume":"12","author":"Santini, M.; Alexidou, G.; Porto, M.P.; Santini, A.; Ammirati, F.; Ansalone, G.","year":"1989","unstructured":"Santini M, Alexidou G, Porto MP, Santini A, Ammirati F, Ansalone G. The sick sinus syndrome (SSS): prognosis as function of age, conduction defects and pacing mode [abstract]. PACE 1989;12:1237."},{"key":"ref_4","first-page":"1236","article-title":"Atrial versus sentricular stimulation in sick sinus syndrome: effects on morbidits'","volume":"12","author":"Bianconi, L.; Boccadamo, R.; Di Florino, A.; Carpino, A.; Catalano, F.; Stella, C.","year":"1989","unstructured":"Bianconi L, Boccadamo R, Di Florino A, Carpino A, Catalano F, Stella C, et al. Atrial versus sentricular stimulation in sick sinus syndrome: effects on morbidits' and mortality [abstract]. PACE 1989;12:1236.","journal-title":"and mortality"},{"key":"ref_5","first-page":"16","article-title":"Long-term pacing in sinus node disease: effects of stimulation mode on cardiovascular morbidity and mortality","volume":"116","author":"Rosenqvist, M.; Brandt, J.; Schuller, H.","year":"1988","unstructured":"Rosenqvist M, Brandt J, Schuller H. Long-term pacing in sinus node disease: effects of stimulation mode on cardiovascular morbidity and mortality. Armi Hearty 1988;116:16-22.","journal-title":"Armi Hearty"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1111\/j.1540-8159.1988.tb06277.x","article-title":"Long-term follow-up of patients swith sick sinus syndrome: a comparison of clinical aspects among unpaced, ventricular inhibited paced, and physiologicallypaced groups","volume":"11","author":"Sasaki, Y.; Shimotori, M.; Akahane, K.; Yonekura, H.; Hirano, K.; Endoh, R.","year":"1988","unstructured":"Sasaki Y, Shimotori M, Akahane K, Yonekura H, Hirano K, Endoh R, et al. Long-term follow-up of patients swith sick sinus syndrome: a comparison of clinical aspects among unpaced, ventricular inhibited paced, and physiologicallypaced groups. PACE 1988;11:1575-83.","journal-title":"PACE"},{"key":"ref_7","first-page":"43","article-title":"Atiral pacing f'or sick sinus svndrome","volume":"13","author":"Ni, Rosenqvist","year":"1990","unstructured":"Rosenqvist Ni. Atiral pacing f'or sick sinus svndrome. (Yli C,ards1l 1990;13:43-7."},{"key":"ref_8","first-page":"11","article-title":"LoAgterm tolliw-up of patients treated with \\VI pacing and sequential pacing with special reference to VA retrograde conduLction. I1ACf 988; 1I1: 1(29-34","volume":"3","author":"Fitzpatrick A, Thoedorakis G, Varias P, Kenny RA, Travill CM, IngIam A, al!.","year":"1","unstructured":"Ebagosti A, Gueunoun NI, Saadjian A, Doila E, Gabriel MN, Levy S,.t al. LoAgterm tolliw-up of patients treated with \\VI pacing and sequential pacing with special reference to VA retrograde conduLction. I1ACf 988;1I1: 1(29-34. 1 3 Fitzpatrick A, Thoedorakis G, Varias P, Kenny RA, Travill CM, IngIam A, al!. I he incidence of malignanit vasovagal syndrome in paticnts with recurrent syncopc. Fir Hearty 1901;12:389-94 14 IPacemakers-practice and paradox. Latmicc M 1;338: 11 78-0.","journal-title":"Latmicc M; I he incidence of malignanit vasovagal syndrome in paticnts with recurrent syncopc. Fir Hearty 1901; 12: 389-94 14 IPacemakers-practice and paradox"}],"container-title":["BMJ"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/data.bmj.org\/tdm\/10.1136\/bmj.305.6858.861","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmj.305.6858.861","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T05:06:27Z","timestamp":1766379987000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.bmj.com\/lookup\/doi\/10.1136\/bmj.305.6858.861"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1992,10,10]]},"references-count":8,"journal-issue":{"issue":"6858","published-online":{"date-parts":[[1992,10,10]]},"published-print":{"date-parts":[[1992,10,10]]}},"alternative-id":["10.1136\/bmj.305.6858.861"],"URL":"https:\/\/doi.org\/10.1136\/bmj.305.6858.861","relation":{},"ISSN":["0959-8138","1468-5833"],"issn-type":[{"type":"print","value":"0959-8138"},{"type":"electronic","value":"1468-5833"}],"subject":[],"published":{"date-parts":[[1992,10,10]]}}}