Prashanthan Sanders1, Allison T Connolly2, Yelena Nabutovsky2, Avi Fischer2, Mohammad Saeed3. 1. Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia. Electronic address: prash.sanders@adelaide.edu.au. 2. Abbott, Chicago, Illinois. 3. Texas Heart Institute, Houston, Texas.
Abstract
OBJECTIVES: The purpose of this study was to evaluate the effect of these therapies on healthcare utilization in a large patient cohort. BACKGROUND: Antitachycardia pacing (ATP) terminates ventricular tachycardia and avoids delivery of high-voltage shocks. Few data exist on the impact of shocks on healthcare resource utilization compared with ATP. METHODS: PROVIDE (Programming Implantable Cardioverter Defibrillators in Patients With Primary Prevention Indication) was a prospective study of patients who received an implantable cardioverter-defibrillator (ICD) for primary prevention at 97 U.S. centers (2008 to 2010). We categorized the PROVIDE patients by the type of therapy delivered: no therapy, ATP only, or at least 1 shock. All ICD therapies, hospitalizations, and deaths were adjudicated. Cumulative cardiac hospitalizations, risk of all-cause death or cardiac hospitalization, and annual costs were compared between groups. RESULTS: Of the 1,670 patients in PROVIDE, followed up for 18.1 ± 7.6 months, 1,316 received no therapy, 152 had ATP only, and 202 received at least 1 shock. Patients receiving no therapy and those receiving only ATP had a lower cumulative hospitalization rate and were at lower risk for death or hospitalization (hazard ratio: 0.33 [p < 0.001] and 0.33 [p < 0.002], respectively). The cost of hospitalization was $2,874 per patient-year (95% confidence interval: $877 to $5,140; p = 0.002) higher for those receiving at least 1 shock than for those who received ATP only. There was no difference in outcomes or cost between patients receiving only ATP and those without therapy. CONCLUSIONS: Among patients implanted with an ICD for primary prevention, those who received only ATP therapy had reduced hospitalizations, mortality, and cost compared with those who received at least 1 high-voltage shock and had equivalent outcomes to patients who did not require any therapy. (Programming Implantable Cardioverter Defibrillators in Patients With Primary Prevention Indication [PROVIDE]; NCT00743522). Crown
OBJECTIVES: The purpose of this study was to evaluate the effect of these therapies on healthcare utilization in a large patient cohort. BACKGROUND: Antitachycardia pacing (ATP) terminates ventricular tachycardia and avoids delivery of high-voltage shocks. Few data exist on the impact of shocks on healthcare resource utilization compared with ATP. METHODS: PROVIDE (Programming Implantable Cardioverter Defibrillators in Patients With Primary Prevention Indication) was a prospective study of patients who received an implantable cardioverter-defibrillator (ICD) for primary prevention at 97 U.S. centers (2008 to 2010). We categorized the PROVIDE patients by the type of therapy delivered: no therapy, ATP only, or at least 1 shock. All ICD therapies, hospitalizations, and deaths were adjudicated. Cumulative cardiac hospitalizations, risk of all-cause death or cardiac hospitalization, and annual costs were compared between groups. RESULTS: Of the 1,670 patients in PROVIDE, followed up for 18.1 ± 7.6 months, 1,316 received no therapy, 152 had ATP only, and 202 received at least 1 shock. Patients receiving no therapy and those receiving only ATP had a lower cumulative hospitalization rate and were at lower risk for death or hospitalization (hazard ratio: 0.33 [p < 0.001] and 0.33 [p < 0.002], respectively). The cost of hospitalization was $2,874 per patient-year (95% confidence interval: $877 to $5,140; p = 0.002) higher for those receiving at least 1 shock than for those who received ATP only. There was no difference in outcomes or cost between patients receiving only ATP and those without therapy. CONCLUSIONS: Among patients implanted with an ICD for primary prevention, those who received only ATP therapy had reduced hospitalizations, mortality, and cost compared with those who received at least 1 high-voltage shock and had equivalent outcomes to patients who did not require any therapy. (Programming Implantable Cardioverter Defibrillators in Patients With Primary Prevention Indication [PROVIDE]; NCT00743522). Crown
Authors: Shibu Mathew; Ardan M Saguner; Niklas Schenker; Lukas Kaiser; Pengpai Zhang; Yoshiga Yashuiro; Christine Lemes; Thomas Fink; Tilman Maurer; Francesco Santoro; Peter Wohlmuth; Bruno Reißmann; Christian H Heeger; Roland Tilz; Erik Wissner; Andreas Rillig; Andreas Metzner; Karl-Heinz Kuck; Feifan Ouyang Journal: J Am Heart Assoc Date: 2019-03-05 Impact factor: 5.501
Authors: Diana M Frodi; Maarten Z H Kolk; Joss Langford; Tariq O Andersen; Reinoud E Knops; Hanno L Tan; Jesper H Svendsen; Fleur V Y Tjong; Soeren Z Diederichsen Journal: Cardiovasc Digit Health J Date: 2021-10-13