The Best Types of Pacemakers

Alexis Gorin
Farah Laiwalla
Engineering Biomedical Systems (BI920-3B)
Thursday, July 17, 2008

The Best Types of Pacemakers

In terms of what they for, each type of pacemaker is better suited for certain pathologies, such as how a double-chamber pacemaker is better when one needs to produce an atrial contraction while the triple-chamber pacemaker is better for those who have problems that can eventually lead to heart failure (Olshansky, MD, Hayes, MD). One even better example is the choice between a temporary or permanent pacemaker, which are used depending on what the patient's need is. Therefore, all pacemakers are the best, considering whatever pathology one is trying to fix.

In general though, comparing dual-chamber pacemakers to ventricular pacing, it has been found that dual-chamber is better. According to the Canadian Trial of Physiologic Pacing and the Mode Selection Trial, while they both share similar results, dual-chamber pacemakers do extra by also reducing heart failure symptoms for those who have sinus node dysfunction, chances for pacemaker syndrome, and atrial fibrillation (Hussein, Hennekens, Lamas and Castelnuovo, Stein Pitt, Garside, Payne).

In the market, there are also pacemakers that can allow the heart to beat naturally unless it acts abnormally, which I find better than pacemakers that control the heart through electricity. Unless the heart always acts abnormally, in which case it would probably be easier to use a pacemaker that took total control of the heart, if the heart is allowed to beat on its own, it seems like it would be a waste to use the other type of pacemaker which probably uses more energy. Pacemakers that can adjust to the wearer’s activity are also better than other pacemakers, seeing as that they can allow the wearer to live a life that is there own. (Keeping the Beat: Artificial Pacemakers)

Appendix

Castelnuovo, Stein Pitt, Garside, Payne, E, K, M, R, E. "The effectiveness and cost-effectiveness of dual-chamber pacemakers compared with single-chamber pacemakers for bradycardia due to atrioventricular block or sick sinus syndrome: systematic review and economic evaluation." NCBI. 09 Nov 2005. Department of Health & Human Services. 17 Jul 2008 http://www.ncbi.nlm.nih.gov/pubmed/16266560?ordinalpos=6&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum.

Hussein, Hennekens, Lamas, SJ, CH, GA. "An update on clinical trials in pacing: is dual chamber pacing better?" NCBI. 19 Jan 2005. Department of Health & Human Services . 17 Jul 2008 http://www.ncbi.nlm.nih.gov/pubmed/14688628?ordinalpos=9&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum.

"Keeping the Beat: Artificial Pacemakers." The Merck Manuals Online Medical Library. 1995-2008. Merck. 17 Jul 2008 .

Olshansky, MD, Hayes, MD, Brian, David L. "Patient information: Pacemakers." UpToDate: For Patients. 2008. UpToDate Patient Preview. 17 Jul 2008 http://www.uptodate.com/patients/content/topic.do?topicKey=hrt_dis/9666.

"Pacemaker." Heart Rhythm Society. Heart Rhythm Society. 17 Jul 2008 .