Cost-effectiveness of implantable defibrillator as first-choice therapy versus electrophysiologically guided, tiered strategy in postinfarct sudden death survivors : a randomized study
作者： Eric F.D. Wever , Richard N.W. Hauer , Guus Schrijvers , Frans J.L. van Capelle , Jan G.P. Tijssen
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摘要: Background Rising costs of health care, partly as a result costly therapeutic innovations, are concern to both the medical profession and healthcare authorities. The implantable cardioverter-defibrillator (ICD) is still not remunerated by Dutch insurers. aim this study was evaluate cost-effectiveness early implantation ICD in postinfarct sudden death survivors. Methods Results Sixty consecutive survivors cardiac arrest caused ventricular tachycardia or fibrillation were randomly assigned either first choice (n=29) tiered therapy starting with antiarrhythmic drugs guided electrophysiological (EP) testing (n=31). Median follow-up 729 days (range, 3 1675 days). Fifteen patients died, 4 group 11 EP-guided strategy (P=.07). For quantitative assessment, ratio calculated for groups expressed median total per patient day alive. Because effectiv...
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