Pacing and Implantable Cardioverter Defibrillator Options for the Elderly in Australia and New Zealand.
This review seeks to determine the extent to which age impacts the access to pacemaker and implantable cardioverter defibrillator (ICD) technology in Australia and New Zealand. The limited available data suggest a number of consistent trends: 1) implant rates for both pacemakers and ICDs are increasing in both Australia and New Zealand; 2) the elderly are increasingly well catered for in terms of pacemaker implantation, especially in Australia (54% of pacemaker recipients aged at or above 80 in 1997); 3) there is a progressive trend to more dual chamber pacing in the elderly in both countries; 4) age appears to be a barrier to the access to ICDs, especially in New Zealand, which is likely related to the high cost of these devices; and 5) limited data suggest that Australia physicians consider age less of a barrier to the access to high technology implantable devices, compared with their New Zealand counterparts, likely reflecting their greater prosperity and financial commitment to health care. Finally, this review clearly documents the need for improved prospective data collection in both countries. (c)1999 by CVRR, Inc.
McAlister
Hugh F.
HF
Department of Cardiology, Waikato Hospital, Hamilton, New Zealand.