The research also suggests that doctors may be able to categorize their patients according to their individual risk factors, to determine who might get the largest benefit from the expensive devices, called implanted cardiac defibrillators, or ICDs. The studies also reinforce the importance of providing good follow-up care to all heart failure patients, whether or not they receive an implanted device.

With Medicare poised to start covering ICDs for many more patients than ever before, the new results come just in time to help doctors decide which patients might get the greatest benefit from the costly devices. More than half a million more people may qualify for ICDs, which cost around $20,000, under Medicare guidelines that will take effect soon.

The data were presented here today in two talks at the Scientific Sessions of the American Heart Association by a U-M Cardiovascular Center team that analyzed data from 7,000 veterans treated for heart trouble in Veterans Affairs hospitals between 1995 and 1999. All had congestive heart failure, heart muscle damage caused by clogged blood vessels, and a heart rhythm irregularity called ventricular arrhythmia. Of the 7,000 patients, 1,442 had received an ICD.

The researchers found that those who received an ICD were 60 percent less likely to die in the next year, and 48 percent less likely to die in three years, than those who did not receive an ICD. Most of this reduction in death risk was due to reduction in heart-related deaths. ICDs are specifically designed to prevent sudden cardiac death, in which the heart's electrical system goes haywire, causing it to stop beating.

But ICD recipients who had co-existing medical conditions, especially diabetes or kidney failure, were much more likely to
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
8-Nov-2004