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Discussion

Pacer and Defibrillators

We are currently setting up an EP lab with our new cath lab renovations. This will include ablations, and insertion of pacers/devices.

I am having a lot of trouble trying to find information regarding which of the big three to use as far as pacers/devices. We curently use Boston for our pacers but will soon be adding defibrillators as well.

Does anyone have good side by side comparisons for which leads have the most lead fractures or skin breakdown, etc. I want to continue with Boston but I need to have good data to make a safe decision for our patients.

Thank You

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    • Admin

    Our Electrophysiologist is the one who makes decisions about which devices to implant.

    He uses two vendors for pacemakers and one for defibrillators.

    Caveat: We may not use a vendor if the company does not have a fiduciary relationship with the hospital.

    I'm sure each EP will have his preferences and reasons for those preferences.

    Good luck with the new setup/renovations, this is an exciting time for you!

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    • Author

    Although our EP has mentioned which he would like to use, we still need to make decisions not on prefernece, price, deals, etc. It really should be based on patient safety and long term health care cost.

    Will the patient be at risk for needing Lead extraction or premature generator change? That is what I am really trying to find out. Because good solid data will either agree with an EP doc or push him/her to use a better product.

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    I've never known of any facility that gets to chose this, it's solely up to the MD. Facilities are free to make suggestions, raise concerns, etc, but aside from that patient's get brand of device their EP doc uses.

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    ours was up to the MD. One was exclusively ST Jude.

    Each md had their preferences ( which were all different)

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    For pacers and defibs we use St Jude and Medtronic predominantly, but it is up to the MD inserting the device as to which company to use. I have noted no difference in device replacement/removal or problems between the two companies.

    We don't use "Boston", probably because am in Australia. :)

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    I agree with the other posts. The EP doc is going to be making the decision on which device he or she is going to use. Each of the major three (St. Jude, Boston, and Medtronic) have different programming options and sizes and battery life. A good EP specialist is going to choose which is the best for each individual patient. For a good resource for electrophysiology information the leading source is the Heart Rhythm Society at www.hrsonline.org

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