Cost-effectiveness of dual-chamber pacemaker therapy: does single lead VDD pacing reduce treatment costs of atrioventricular block?
Eur Heart J
; 22(2): 174-80, 2001 Jan.
Article
em En
| MEDLINE
| ID: mdl-11161919
ABSTRACT
AIMS:
Implantation of single-lead VDD pacemakers is an established alternative to DDD pacing in patients with atrioventricular block. This study compares the long-term costs of both systems. METHODS ANDRESULTS:
Three hundred and sixty patients with atrioventricular block received VDD or DDD pacemakers in alternating order. Primary costs of implantation included devices, leads and operation material, surgeons, nurses, medical technicians, and hospitalization. The mean cost of an uncomplicated DDD pacemaker implantation was defined as 1000 virtual cost-units (CU). Costs of pacemaker related complications or re-operations as well as upgrades from VDD to DDD devices were considered secondary costs and assessed during a mean follow-up period of 42+/-15 months. Pacing efficacy was assessed by event-free survival with maintained atrioventricular synchronized pacing mode. Costs of pacemaker devices were not different (639+/-26 CU in VDD vs 641+/-32 CU in DDD, ns). However, due to lower costs of lead hardware (102+/-10 CU in VDD vs 133+/-14 CU in DDD, P<0.001) and shorter implantation procedures (44.3+/-5.1 min vs 74.4+/-13.5 min, P<0.001), costs of an uncomplicated implantation were 8.9% lower in the VDD group (911+/-35 CU vs 1000+/-39 CU, P<0.001). A smaller complication rate in the VDD group led to a 16.1% reduction of secondary costs (26+/-17 CU year(-1)vs 31+/- 25 CU year(-1), P=0.024). Event-free survival did not differ between groups (83.4% in VDD vs 84.9% in DDD, ns).CONCLUSION:
Use of single-lead VDD pacemakers achieves significant reduction of implantation and follow-up costs without loss of therapeutic efficacy compared to conventional DDD systems.
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Temas:
ECOS
/
Aspectos_gerais
/
Financiamentos_gastos
Bases de dados:
MEDLINE
Assunto principal:
Marca-Passo Artificial
/
Estimulação Cardíaca Artificial
/
Bloqueio Cardíaco
Tipo de estudo:
Health_economic_evaluation
/
Observational_studies
/
Prognostic_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Eur Heart J
Ano de publicação:
2001
Tipo de documento:
Article
País de afiliação:
Alemanha