Abstract
There is no doubt that thanks to the large-scale availability of pacemakers and cardioverter-defibrillators, the life expectancy and quality of life of numerous patients has much improved. Pacemakers are used since a long time, they have proven their value, and they have become big business for the industry, scientists, and cardiologists.1 Although technical innovation has resulted in safer and more effective pacemakers, thereby reducing the number of adverse effects and improving patient compliance, it has also created three areas of potential conflicts of interest:
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1.
Innovation may still have to prove its value for the patient. Extensive clinical testing and patient follow-up studies are then required, for which recognized end-points within the framework of evidence-based medicine are needed.2
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2.
As pacemakers are widely used, innovation may yield enormous financial rewards to the industry and cardiologists. This could interfere with safety priorities, the patient-doctor relation, and the cardiologists’ independence of the industry.3, 4
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3.
As pacemakers and cardioverter-defibrillators are potentially life-saving devices, cardiologists may adopt a liberal policy in terms of the indication for use. This might lead to technical and budgetary disputes on what should be considered an appropriate indication.5
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de Mol, B.A.J.M. (1995). The Safety and Medico-Legal Responsibilities of the Pacemaker Implantation Team. In: Van Hemel, N.M., Wittkampf, F.H.M., Ector, H. (eds) The Pacemaker Clinic of the 90’s. Developments in Cardiovascular Medicine, vol 175. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-0347-3_14
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DOI: https://doi.org/10.1007/978-94-011-0347-3_14
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