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October 11, 1985

The Use of Cardiac Pacemakers in Medical Practice: Excerpts From the Report of the Advisory Panel

Author Affiliations

From the Council on Scientific Affairs, Division of Drugs and Technology, American Medical Association, Chicago.

JAMA. 1985;254(14):1952-1954. doi:10.1001/jama.1985.03360140110036

IN SEPTEMBER 1982, the Senate Select Committee on Aging reported on a year-long investigation of problems related to the purchase and use of pacemakers under Medicare coverage.1 Questions were raised about device performance, application of warranty provisions, cost of pacemaker therapy, and medical reimbursement policies. Other issues opened to query included alleged overutilization of pacemakers, the increasing proficiency needed by physicians who perform pacemaker implantations, the role of the pacemaker sales representative in dealing with the medical profession, and the essential equipment and skilled personnel required for pacemaker implantation facilities. The Senate committee recommended reestablishment of the pacemaker registry sponsored by the Food and Drug Administration until it was discontinued in 1980. The committee suggested that pacemaker centers be established to treat patients who need more difficult or complex pacemaker instrumentation.

In 1982, the Inspector General of the Department of Health and Human Services reviewed the Veterans Administration's experience