ICDs deliver electrical shocks to the heart to eliminate abnormal rhythms such as ventricular fibrillation or ventricular tachycardia. In the Antiarrhythmics Versus Implantable Defibrillators (AVID) trial, the device was shown to be superior to therapy with antiarrhythmic medications for reducing all causes of death in survivors of ventricular fibrillation (irregular, chaotic heart rhythm that begins in the hearts lower chambers). It was also a better choice for people with ventricular tachycardia (an often serious rapid rhythm originating in the lower chambers) and ejection fractions of 40 percent or less. Ejection fraction is a measure of the hearts pumping ability.
AVID is the first study to prospectively determine the cost-effectiveness of ICDs for secondary prevention in the United States, according to lead author Greg Larsen, M.D, a staff cardiologist at the Portland VA Medical Center and associate professor of medicine at the Oregon Health and Sciences University, Portland, Oregon. The study looked only at treating patients who had had life-threatening arrhythmias and were at risk for another life-threatening event. Researchers compared life gained and costs due to ICD treatment with that of antiarrhythmic drug therapy.
To find out which treatment was more cost-effective, researchers compiled data on charges for initial and repeat hospitalizations, emergency room and day surgery stays, and the costs of antiarrhythmic drugs from 1,008 patients. These included 505 patients with an ICD.
Detailed records of all other medical encounters and expenses, including outpatient services and prescription costs, were
Contact: Carole Bullock
American Heart Association