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Pacemaker therapy halves heart failure deaths

Using specialized pacemakers to recharge the weakened hearts of heart failure patients can halve the death rate from the disease and reduce hospitalizations by nearly a third, a Johns Hopkins study has found.

Results of the study, which analyzed clinical trials of pacemaker therapy for heart failure involving a total of 1,634 patients, are published in the Feb. 12 issue of The Journal of the American Medical Association.

"The devices range in cost from $20,000 to $50,000," says lead author David J. Bradley, M.D., Ph.D., a cardiology fellow. "These specialized pacemakers have been known to improve the quality of life for heart failure patients, but whether they also save lives had been unclear."

Heart failure accounts for more than 700,000 hospitalizations among Medicare beneficiaries every year, Bradley says. In the year 2000, hospitalization charges amounted to $14 billion. Half of deaths among these patients are caused by progressive cardiac dysfunction, which pacemakers help correct by stimulating the heart muscle to contract, pumping blood to the body.

Heart failure, which affects nearly 5 million people in the United States, is a condition in which the heart can't pump enough blood to the body's other organs. This can result from assorted problems including heart attack, high blood pressure or heart valve disease. The "failing" heart keeps working but not as efficiently as it should. People with heart failure can't exert themselves because they become short of breath and tired.

Advances in technology have increased the number of people diagnosed with heart failure each year, says senior author Neil R. Powe, M.D., M.P.H., director of Johns Hopkins' Welch Center for Prevention, Epidemiology and Clinical Research. About 550,000 new patients are diagnosed annually, he says.

"We can often save heart attack patients with drugs like thrombolytics or with angioplasty, but they survive with weakened hearts, and ofte
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Contact: John Lazarou
jlazaro1@jhmi.edu
410-502-8902
Johns Hopkins Medical Institutions
11-Feb-2003


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