Early intervention with ICDs: Saving lives and money

Researchers have introduced the concept that the cost of extending life with a defibrillator in young and otherwise healthy subjects with genetic cardiac disorders can be balanced by society gains when the lifespan of an individual is considered. Through computer-based analytical models, the study, published in Annals of Noninvasive Electrocardiology, shows that primary intervention with defibrillator therapy is cost-effective and even cost-gaining in this population.

Defibrillator therapy, the implantation of a defibrillator in patients with high-risk genetic cardiac disorders, but without a history of prior aborted cardiac arrest, used in early intervention can reduce the risk of sudden cardiac death and significantly prolong life, say researchers.

"The implanted cardioverter defibrillator has been shown to efficiently terminate life-threatening arrhythmias affecting patients born with genetic abnormalities in the electrical system of the heart," states Dr. Ilan Goldenberg of the Heart Research Follow-Up Program at the University of Rochester Medical Center. "However, data on the yield of this mode of therapy derives mostly from studies of adult patients with acquired cardiac disease. In the present study, we employ an analytical model based on current knowledge of the risks of patients with genetic cardiac disorders and show that in this high-risk population, intervention with a defibrillator at the age of 10 years is cost effective or even associated with economic gains due to the societal contributions of young and otherwise healthy patients in whom defibrillator therapy extends life."

Defibrillator therapy was found to be beneficial and cost effective with a ratio in the range of $30,000 to $185,000 per quality-adjusted-life-year saved in adult patients with acquired heart disease. In high-risk young males and females with genetic cardiac disorders, implantation of a defibrillator resulted in cost savings in the range of $15,000 to $20,000 per quality-adjusted-life-year saved.

This study is published in Annals of Noninvasive Electrocardiology. Media who would like to receive a PDF of this article should contact medicalnews@bos.blackwellpublishing.net.

Ilan Goldenberg, MD is currently performing research at the Heart Research Follow-up Program in which the International Long QT Syndrome Registry, one of the world's largest databases of patients with inherited cardiac disorders, is being carried out. The work in this paper is a result of collaboration between an experienced team of statisticians and preventive medicine experts in the field of Long QT Syndrome.

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About the Journal
The Annals of Noninvasive Electrocardiology (A.N.E) is the first journal in an evolving subspecialty that incorporates ongoing advances in the clinical application and technology of traditional and new ECG-based techniques in the diagnosis and treatment of cardiac patients. The publication includes topics related to 12-lead, exercise and high-resolution electrocardiography, arrhythmias, ischemia, repolarization phenomena, heart rate variability, circadian rhythms, bioengineering technology, signal-averaged ECGs, T-wave alternans and automatic external defibrillation.

About Blackwell Publishing
Blackwell Publishing is the world's leading society publisher, partnering with more than 665 academic, medical, and professional societies. Blackwell publishes over 800 journals and, to date, has published close to 6,000 text and reference books, across a wide range of academic, medical, and professional subjects.


Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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