Cardioverter-defibrillators: a cost or an investment?
Open Access
- 25 April 2011
- journal article
- research article
- Published by Oxford University Press (OUP) in EP Europace
- Vol. 13 (suppl 2), ii25-ii31
- https://doi.org/10.1093/europace/eur085
Abstract
Implantable cardioverter-defibrillator (ICD) therapy has emerged as the most effective treatment for life-threatening ventricular arrhythmias. Most studies indicate that ICD therapy in appropriately selected patients at high risk of sudden cardiac death (SCD) is associated with cost-effectiveness ratios similar to, or better than, other accepted treatments, including renal dialysis. The up-front costs of ICD therapy are admittedly high and as such, ICD implantation is more akin to an operation than a drug. As would be the case for a life-saving operation, the adoption of short time horizons is apt to lead to underestimations of cost effectiveness. As well as the time horizon, the underlying aetiology of the arrhythmic substrate, implantation technique, ICD battery life, and the presence of co-morbidities are important issues in maximizing cost effectiveness. Above all, we should consider that ICD therapy is the only available option for prolonging survival in patients who are at risk of SCD.Keywords
This publication has 30 references indexed in Scilit:
- Lifetime cost-effectiveness of prophylactic implantation of a cardioverter defibrillator in patients with reduced left ventricular systolic function: results of Markov modelling in a European populationEP Europace, 2009
- Maximum potential benefit of implantable defibrillators in preventing sudden death after hospital admission because of heart failureCMAJ : Canadian Medical Association Journal, 2009
- The cost of implantable defibrillators: how the perception of reality depends on perspectiveEuropean Heart Journal, 2007
- Primary Prevention of Sudden Cardiac Death: Can We Afford the Cost of Cardioverter‐Defibrillators? Data from the Search‐MI Registry‐Italian Sub‐studyPacing and Clinical Electrophysiology, 2006
- National Institute for Clinical Excellence and its value judgmentsBMJ, 2004
- Long-Term Comparison of the Implantable Cardioverter Defibrillator Versus AmiodaroneCirculation, 2004
- Prophylactic Implantation of a Defibrillator in Patients with Myocardial Infarction and Reduced Ejection FractionThe New England Journal of Medicine, 2002
- A Randomized Study of the Prevention of Sudden Death in Patients with Coronary Artery DiseaseThe New England Journal of Medicine, 1999
- Prophylactic Use of Implanted Cardiac Defibrillators in Patients at High Risk for Ventricular Arrhythmias after Coronary-Artery Bypass Graft SurgeryThe New England Journal of Medicine, 1997
- Termination of Malignant Ventricular Arrhythmias with an Implanted Automatic Defibrillator in Human BeingsThe New England Journal of Medicine, 1980