Implantation of pacemakers has become an established approach to bradycardia due to sinoatrial node disease or atrioventricular block and is becoming a more common procedure. Two different types of pacemakers are available to treat bradycardia, single and dual chamber pacemakers. Despite dual chamber pacemaker have shown to have a better cardiac rhythm control, it use is nowadays limited in Spain. OBJECTIVE: To adapt an existing economic model of managing bradycardia with a dual vs. single chamber ventricular pacemaker to estimate the long-term economic and health impact of these devices in Spain METHODS: A discrete event simulation model was adapted for the Spanish setting. A cohort of 1,000 patients was created, characteristics were assigned to each individual and then each patient is cloned. One clone received a dual chamber device, the other a single chamber one. During the simulation, each patient may develop different clinical events, complications and adverse events. Clinical data were retrieved from published trials, and resource use and costs were obtained from the Hospital of Granollers. Time horizon contemplated was 5 years. The perspective of the analysis was the NHS, so only direct costs were included. Costs and benefits were discounted at 3%. RESULTS: Based on 100 replications, the mean costs per patient in the dual chamber arm exceeded in €331 respect single chamber patients. The dual chamber patients were predicted to increase the discounted QALY by a mean 0.09 years. The mean cost-effectiveness ratio was €3,678 per discounted QALY. Sensitivity analyses showed the results to be consistent over broad ranges. CONCLUSIONS: The use of dual chamber devices in patients with bradycardia due to sinoatrial node disease or atrioventricular block, is an efficient technology compared to single chamber, in the Spanish setting, with a C/E rate below the accepted Spanish threshold (30,000 €/QALY).