Trends in the Use of Permanent Pacemakers in Australia: A Nationwide Study from 2008–2017

Abstract

Background: There is an increasingly ageing and comorbid population in Australia. Although prior studies have demonstrated that permanent pacemaker (PPM) insertions were rising in this context, there is a lack of contemporary data. Methods: Data from the Australian Institute of Health and Welfare were analysed to determine the annual nationwide number of PPM generator and electrode insertions, plus replacement, removal and adjustment procedures between 2008–2017. Rates were calculated using the mid-year estimated population from the Australian Bureau of Statistics. Results: PPM generator insertions increased from 12,153 in 2008–09 to 17,862 in 2016–17. As a percentage of all cardiovascular procedures, generator insertion increased from 2.14% to 2.99%. Generator insertion rates increased from 55.3 to 72.6 per 100,000 with rises seen in all age groups. In contrast, generator replacements decreased from 20.5 to 18.3 per 100,000. The highest proportion of generator insertions was in the 80+ age group (46.6%) and in males (58.4%). Although the rate of generator insertions increased in all age groups and both genders, the proportion of insertions appeared stable across age groups and gender, with the greatest absolute increase seen in the 80+ age group. Conclusions: The rate and number of PPMs increased in Australia between 2008–2017, while the rate of PPM generator replacements decreased. This increasing demand for pacing services is in large part driven by an ageing population, in addition to rising insertion rates across all age groups. Our evidence supports a continued increase in future pacing demand and has significant implications for healthcare planning.