5 Recommendations for further research

5.1 The publication of the UKPACE trial will provide additional data on a number of outcomes including quality of life with dual‑chamber pacemakers compared with single‑chamber ventricular pacemakers.

5.2 The ongoing DANPACE trial will provide additional information on the effectiveness of dual‑chamber pacing compared with single‑chamber atrial pacing in patients with sick sinus syndrome without atrioventricular block.

5.3 The Institute recommends that further studies evaluate the incidence of mild pacemaker syndrome, and utilities associated with health states of mild and severe pacemaker syndrome.

5.4 Future studies should evaluate the effectiveness of rate‑responsive compared with non‑rate‑responsive pacemakers.

5.5 Further research is also recommended into the predictors for the development of atrioventricular block in sick sinus syndrome, to enable clinicians to determine people for whom single‑chamber atrial pacing is appropriate.

5.6 Further studies should evaluate the effectiveness of dual‑ and single‑chamber pacing at follow‑up beyond 5 years (where possible, up to 10 years) for outcomes of mortality, stroke, heart failure, atrial fibrillation and pacemaker syndrome.