Pacemaker Use Questioned

More than half of all the pacemakers installed by doctors in one city were of questionable value or clearly not needed, according to a review of medical records. The study blamed the useless operations on physician ignorance, not greed.

The findings were based on a review of operations in Philadelphia five years ago. Dr. Allan M. Greenspan, the report’s chief author, said the situation has probably improved somewhat since then, because insurance companies now demand proof that pacemakers are necessary before they will pay for them.

“The results of our study suggest that a significant percentage of pacemakers were being put in for incorrect reasons. Twenty percent of the implants that were done were not necessary, and another 36% were questionable,” said Greenspan, a cardiologist at Albert Einstein Medical Center in Philadelphia.

Pacemakers are usually installed when the heart beats too slowly. They electrically stimulate the heart to work more quickly. An estimated one in 500 Americans has a permanent pacemaker, and doctors put in about 120,000 new ones each year. The pacemakers cost about $10,000 each.