Review of NICE Technology Appraisal Guidance No 88; Dual-chamber pacemakers for symptomatic bradycardia due to sick sinus syndrome and/or atrioventricular block

In September 2011, the Institute carried out a consultation on our plans for a review of TA88; ‘Dual-chamber pacemakers for symptomatic bradycardia due to sick sinus syndrome and/or atrioventricular block’

The Institute proposed that a review of TA88 should be planned into the NICE’s work programme, and that a revised remit will be sought from the Department of Health to clarify the indications for which the technology will be appraised.

A limited amount of responses were received and these were equally divided between support for and opposition to the review. One stakeholder requested that a review is not undertaken because only a limited number of patients (around 200) are currently receiving single-lead atrial pacing so an update would only potentially affect a small population. This suggests that the use of dual chamber pacing has already expanded to include the additional patients for whom the evidence suggests it might be indicated and that there may be little value in an update of the appraisal even though the evidence suggests that the recommendations require update.  Consequently, the Institute proposes that TA88 will be withdrawn in full and the existing funding direction removed.

In order to be completely confident that this is appropriate, we are asking consultees and commentators to notify as to whether this course of action is deemed appropriate.  Please see appendix A for a full list of organisations that we have contacted.

August 2012