ORGANIZATION, EVALUATION AND MANAGEMENT OF PACEMAKER FOLLOWUP DATA

The proliferation of different pacemaker systems and the widespread use of programmable units with a large number of adjustable parameters have made the orderly collection and evaluation of clinical data essential for accurate prediction of long term performance. Due to lead fracture, battery depletion and other random modes of failure, an orderly schedule of followup is essential.; A computer system has been developed for the Northern California and Nevada Veterans' Administration hospitals to aid a nurse practitioner in the surveillance of pacemaker patients. The computer system provides assistance in: (1) establishing and maintaining patient records, (2) collecting and evaluating the essential information concerning the function of the patient's pacing system, (3) creating detailed and summary reports of patients seen and anomalies discovered, and (4) establishing a patient call schedule. The system has been in daily use since October 1978. Ability of the system to satisfy a set of stated operational goals is evaluated.; Using data collected by the system, a model of pacemaker battery failure is developed for mercury-zinc battery powered pacemakers. The model utilizes statistics appropriate to "censored" data for failure times, permitting recovery of maximum information content from the data prior to failure of all of the units. Use of this model to develop individualized followup schedules would permit the followup effort to be directed more closely to units more likely to fail.