Enhancing longevity of pacemakers through reprogramming. Underutilization and cost-effectiveness

OBJECTIVE: This study was performed to observe the number of pacemakers that had never been reprogrammed after implantation, and the effect of optimised output programming on estimated longevity of pulse generators in patients with pacemaker METHODS: Sixty patients with Teletronics Reflex pacemakers were evaluated in a pacemaker clinic, from the time of the beginning of its activities, in June 1998, until March 1999. Telemetry was performed during the first clinic visit, and we observed how many pulse generators retained nominal output settings of the manufactures indicating the absence of reprogramming until that date. After evaluation of the capture threshold, reprogramming of pacemakers was performed with a safety margin of 2 to 2.5:1, and we compared the estimated longevity based on battery current at the manufacturer's settings with that based on settings achieved after reprogramming. RESULTS: In 95% of the cases, the original programmed setting was never reprogrammed before the patients attended the pacemaker clinic. Reprogramming the pacemaker prolonged estimated pulse generator life by 19.7±15.6 months (35.5%). CONCLUSION: The majority of the pacemakers evaluated had never been reprogrammed. Estimated pulse generator longevity can be prolonged significantly, using this simple, safe, efficacious, and cost-effective procedure.

Os efeitos das políticas industriais para o setor de produtos eletrônicos do Brasil

The effect of industrial policies on the electronic sector in Brazil. Brazil's reputation in vertical industrial policies is dreadful. The electronics industry case is a good example. As measured by the performance of Brazil's exports vis-à-vis that of a group of emerging economies, the result of these policies was a total disaster. Had not been for the inadequacy of Brazil's industrial policies for this sector, exports of manufactures could have been between 36% and 46% higher than they actually were. Brazil's cumulated losses from 1984, when foreign microcomputer firms were prohibited to operate in the country, are estimated to be from 3.6 to 4.6 the country's manufactures export revenue in 2005.