Association Between the Use of an Adaptive Cardiac Resynchronization Therapy Algorithm and Health Care Use and Cost.
J Card Fail
; 2024 Jul 06.
Article
in En
| MEDLINE
| ID: mdl-38977056
ABSTRACT
OBJECTIVES:
To assess the association between the use of adaptive pacing on clinical and economic outcomes of cardiac resynchronization therapy (CRT) recipients in a real-world analysis.BACKGROUND:
The adaptivCRT (aCRT) algorithm was shown in prior subgroup analyses of prospective trials to achieve clinical benefits, but a large prospective trial showed nonsignificant changes in the endpoint of mortality or hospitalizations due to heart failure.METHODS:
CRT-implanted patients from the Optum Clinformatics database with ≥ 90 days of follow-up were included. Remote monitoring data were used to classify patients based on CRT setting-adaptive biventricular and left ventricular pacing (aCRT) vs standard biventricular pacing (Standard CRT). Inverse probability of treatment weighting was used to adjust for baseline differences between groups. Mortality, 30-day readmissions, health care use, and payer and patients' costs were evaluated post-implantation.RESULTS:
This study included 2412 aCRT and 1638 Standard CRT patients (mean follow-up 2.4 ± 1.4 years), with balanced baseline characteristics after adjustment. The aCRT group was associated with lower all-cause mortality rates (adjusted hazard ratioâ¯=â¯0.88 [95% confidence interval (CI)0.80, 0.96]), fewer all-cause 30-day readmissions (adjusted incidence rate ratioâ¯=â¯0.87 [CI0.81, 0.94]), and fewer all-cause and HF-related inpatient, outpatient and emergency department visits. The aCRT cohort was also associated with lower all-cause outpatient payer-paid amounts and lower all-cause and HF-related inpatient and emergency department patient-paid amounts.CONCLUSIONS:
In this retrospective analysis of a large real-world cohort, the use of an adaptive CRT algorithm was associated with lower mortality rates, reduced health care resource use and lower payer and patient costs.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
J Card Fail
Journal subject:
CARDIOLOGIA
Year:
2024
Document type:
Article
Country of publication: