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Cardiac Resynchronization Therapy - Springer Nature

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Last Updated: 10 September 2022

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A long-term cost-effectiveness analysis of cardiac resynchronisation therapy with or without defibrillator based on health claims data

Background and Background CRT devices with defibrillator capability in Germany have become the most common treatment option for patients with heart failure and cardiac dyssynchrony. From a German payer's perspective, we conducted a cost-effectiveness evaluation for CRT-P devices compared to CRT-D devices. Methods Longitudinal health claims data from 3569 patients with novo CRT implantation from 2014 to 2019 were used to create a cohort Markov model for a cohort Markov style. Conclusions The Markov model forecast a median survival of 84 months for CRT-P patients and 92 months for CRT-D patients. Conclusions This modeling report reveals the lack of certainty surrounding the higher use of CRT-D devices relative to CRT-P systems. Given the disparaging difference in incremental costs between CRT-P and CRT-D therapy, there would be significant potential cost savings to the healthcare system if CRT-D devices were limited to patients likely to profit from the additional defibrillator, causing significant potential cost savings to the healthcare industry.

Source link: https://doi.org/10.1186/s12962-022-00384-x


The role of cardiac magnetic resonance in identifying appropriate candidates for cardiac resynchronization therapy — a systematic review of the literature

For at least three months, we considered eligible observational studies or randomized clinical trials that recruited patients > 18 years old with heart disease of ischaemic or non-ischemic aetiology and provided information about baseline CMR variables related to clinical or echocardiographic responses to CRT for at least three months. In addition, new results have shown that scar location can be related to CRT response rates. CMR results can be used to refine the position of the left ventricular lead during the CRT implantation procedure. Specifically, positioning the left ventricular lead in a branch of the coronary sinus that feeds a region of transmural scar tissue was associated with poorer response to CRT. Following CRT implantation, it can be used as a non-invasive optimization tool to identify patients who are more likely to have positive clinical and echocardiographic responses.

Source link: https://doi.org/10.1007/s10741-022-10263-5

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions

* Please keep in mind that all text is summarized by machine, we do not bear any responsibility, and you should always check original source before taking any actions