Penn study finds elderly heart patients with ICD devices live longer after hea...( WASHINGTON D.C. Elderly patients d...),Health

WASHINGTON, D.C. Elderly patients diagnosed with congestive heart failure who receive implantable cardioverter-defibrillators (ICDs) for primary prevention of sudden cardiac death live longer than those that do not, according to researchers at the University of Pennsylvanias School of Medicine. Further, the health care costs associated with ICDs, while substantial at the time of implantation, do not greatly increase downstream health care costs in this population. The study is among the first to analyze the health outcomes and costs associated with primary prevention ICDs for patients outside of a clinical trial setting.

Researchers examined health care data from a nationally representative sample of 14,250 Medicare beneficiaries over age 66 who were treated for congestive heart failure at over 2,000 academic and community hospitals nationwide. Peter Groeneveld, M.D., M.S., Assistant Professor of General Internal Medicine, and his co-authors reported their findings in the May 2008 issue of the journal Heart Rhythm.

Researchers found that, on average, patients receiving ICDselectric monitoring devices that deliver a lifesaving shock to the heartfor primary prevention had a 38 percent lower mortality rate than patients who did not. Thirteen percent of patients who received ICDs died in the first year after implantation, compared with 23 percent of patients who did not receive ICDs. During the second year, the gap widened, as 17 percent of ICD recipients died, compared with 29 percent who did not receive the device.

According to the study, the average cost for ICD recipients in the first 30 days after initial hospitalization was about $42,000 more than for patients who received other treatments for congestive heart failure, which is comparable to cost estimates from previous clinical studies. Excluding the costs of implantation, after six months the total health care costs for ICD recipients were approximately $1,700 higher than
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