Proleta Datta1, Krishna Mourya Galla2, Kalyan Sajja2, Christopher Wichman3, Hongmei Wang4, Deepak Madhavan5. 1. Department of Neurology, University of Nebraska Medical Center, Omaha, NE, United States of America. Electronic address: proleta.datta@unmc.edu. 2. Department of Neurology, University of Nebraska Medical Center, Omaha, NE, United States of America. 3. Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, United States of America. 4. Department of Health Service Research and Administration, University of Nebraska Medical Center, Omaha, NE, United States of America. 5. Boystown National Research Hospital, Boys Town, NE, United States of America.
Abstract
PURPOSE: This study investigates the clinical and cost effectiveness of switching from traditional vagus nerve stimulation (VNS) to responsive VNS (rVNS), which has an additional ictal tachycardia detection and stimulation (AutoStim) mode. METHODS: Retrospective chart review was used to collect data from patients with medically refractory epilepsy who underwent generator replacements. Patients with confounding factors such as medication changes were excluded. Vagus nerve stimulation parameters, seizure frequency, and healthcare costs were collected for the 1-year period following generator replacement with the rVNS device. RESULTS: Documented seizure frequency was available for twenty-five patients. After implant with rVNS, 28% of patients had an additional ≥50% seizure reduction. There was a significant decrease in the average monthly seizure count (p = 0.039). In patients who were not already free of disabling seizures (n = 17), 41.2% had ≥50% additional seizure reduction. There was no difference in healthcare costs during the 1-year follow-up after the rVNS implant compared with one year prior. CONCLUSIONS: Ictal tachycardia detection and stimulation provided a significant clinical benefit in patients who were not free of disabling seizures with treatment from traditional VNS. There was no additional increase in healthcare costs during the first year after device replacement.
PURPOSE: This study investigates the clinical and cost effectiveness of switching from traditional vagus nerve stimulation (VNS) to responsive VNS (rVNS), which has an additional ictal tachycardia detection and stimulation (AutoStim) mode. METHODS: Retrospective chart review was used to collect data from patients with medically refractory epilepsy who underwent generator replacements. Patients with confounding factors such as medication changes were excluded. Vagus nerve stimulation parameters, seizure frequency, and healthcare costs were collected for the 1-year period following generator replacement with the rVNS device. RESULTS: Documented seizure frequency was available for twenty-five patients. After implant with rVNS, 28% of patients had an additional ≥50% seizure reduction. There was a significant decrease in the average monthly seizure count (p = 0.039). In patients who were not already free of disabling seizures (n = 17), 41.2% had ≥50% additional seizure reduction. There was no difference in healthcare costs during the 1-year follow-up after the rVNS implant compared with one year prior. CONCLUSIONS:Ictal tachycardia detection and stimulation provided a significant clinical benefit in patients who were not free of disabling seizures with treatment from traditional VNS. There was no additional increase in healthcare costs during the first year after device replacement.
Authors: Breanne Fisher; Julie A DesMarteau; Elizabeth H Koontz; Seth J Wilks; Susan E Melamed Journal: Front Neurol Date: 2021-01-15 Impact factor: 4.003
Authors: Arjune Sen; Ryan Verner; James P Valeriano; Ricky Lee; Muhammad Zafar; Rhys Thomas; Katarzyna Kotulska; Ellen Jespers; Maxine Dibué; Patrick Kwan Journal: BMJ Neurol Open Date: 2021-12-23