OBJECTIVES: Complications like mechanical lead damage, major infections and hematomas during surgical replacement of pacemaker and implantable cardioverter defibrillator contribute to considerable additional costs for hospitals. This study aimed to evaluate the economic impact if the currently applied traditional surgical intervention (TSI) by using scissors, scalpels and electrocautery is replaced by a new and innovative surgical system, called PEAK PlasmaBlade^TM (PPB). METHODS: A retrospective analysis examined 508 patients with TSI and 84 patients with PPB, who underwent generator replacement at the general hospital in Linz, Austria. Intraoperative complications (lead damages, infections, hematomas) and duration of operating time for TSI and PPB were analyzed. Economic analysis included the costs for personnel, facility and consumables as well as the estimates for the budget impact. RESULTS: Proportion of males (TSI = 59.4%; PPB = 63.1%) and mean age (TSI = 74.3±12.4, PPB = 74.2±12.9 years) were not significantly different between the two groups. The lead damage was significantly higher with TSI than with PPB (5.7% and 0.0%; p= 0.024) and the operation time with TSI was significantly longer than with PPB (47.5±24.0 and 27.8±6.4 minutes; p<0.0001). Other complications, like revisions of hematomas and infections (TSI = 1.6%; PPB = 2.4%), did not significantly differ between TSI and PPB. Reduced costs associated with operation room use, hospital staff and replacement of damaged leads resulted in a cost saving of € 124 per patient when using PPB instead of TSI. Based on estimated 2,600 patients annually undergoing generator replacement in Austria, the use of PPB may result in cost savings of € 321,000. CONCLUSIONS: PEAK PlasmaBlade^TM has the potential to minimize the risk of lead damage while decreasing surgery time, resulting in a more efficient utilization of the operation room. Along with cost savings and improved quality of care hospitals may increase the number of daily surgeries.