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736–6 Economic Impact of Advancing Implantable Cardloverter Defibrillator Technologies: Decreased Monetary Costs and Earlier Hospital Discharge

Journal of the American College of Cardiology
Publication Date
DOI: 10.1016/0735-1097(95)92063-b
  • Economics
  • Medicine


The recent advances in implantable cardioverter defibrillator (ICD) technologies allow ICDs with non-thoracotomy leads (NTL), obviating the need for open chest surgery; smaller generator volumes allow prepectoral implant of NTL-ICDs, obviating the need for abdominal surgery. To formally assess the economic impact of these improvements, the physician and hospitalization charges, (implant to discharge) for 36 patients who received ICD systems (same manufacturer; 9/92 – 1/94) were determined. Nine patients received the ICD epicardial without other cardiac surgery (EPI); 15 received an NTLICD subrectus (NTL AB); 12 received a smaller volume NTL-ICD prepectoral (NTL PP). [P-values are EPI vs NTL AB/NTL AB vs NTL PP]. EPI NTLAB NTL PP p-value Age (Vrs) 66 ± 9 64 ± 15 66 ± 10 ns/ns LVEF (%) 38 ± 16 33 ± 17 35 ± 14 ns/ns Post-op hosp. (d) 8 ± 5 5 ± 3 3 ± 2 0.04/001 Charges ($1,000) 24 ± 9 21 ± 4 13 ± 4 ns/0.004 The prepectoral implant approach for NTL ICDs led to less postoperative hospitalization and at least a 35% lower cost as compared to abdominal NTL or epicardial lCD implant approaches. ICD technology evolution is associated with lower health care resource utilization per patient. This is an example of progress in health technology associated with less monetary costs.

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