Too Many Pacemakers

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Abstract
To the Editor: Rasmussen has discussed chronic sinus-node disease and the indications for the use of permanent cardiac pacemakers.1 He reports the number of pacemakers implanted in patients in 13 countries, as well as the fraction of pacemakers used for sinus-node disease. The United States stands out at the top of the scale. The use of pacemakers in four English-speaking countries is shown in Table 1.These figures (based on 1978 data) are startling, considering that in addition to the common language among these countries, there is a community of thought in the medical sciences as well as in the practice . . .
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