Use of cardiac pacemakers in Britain.

In Britain during 1975 cardiac pacemakers were implanted at the rate of 56 new patients per million population. This is about one-third the rate for other Western countries but still represents an increase of 150% since 1972. Six-thousand generators were used, and apparatus worth about 2m pounds was implanted. Over 90% of the initial implantations were by the transvenous route, and the mortality from this operation was only 0-3%. Electrode repositioning was needed in 10% of cases. The average age of patients at the time of first implantation was 70. Most patients with pacemakers were able to obtain driving licenses and insurance; only 10% had to pay an additional premium. There is no evidence from insurance comparnies that such patients have an increased risk of accidents. Patients who wished to undertake paid employment almost always did so, often in their previous job. About 80% of the patients were able to increase or maintain their leisure activities at the same level of effort as before pacing became necessary. The number of implantations may be expected to increase by about three times over the next five years.