Implantable cardiac defibrillators for primary prevention of sudden cardiac death in high risk patients: a meta-analysis of clinical efficacy, and a review of cost-effectiveness and psychosocial issues
Ho C, Li H, Noorani H, Cimon K, Campbell K, Tang A, Birnie D
Record ID 32007000129
English
Authors' objectives:
The objectives were to examine the clinical and cost effectiveness of implantable cardiac defibrillators (ICDs), small electronic devices implanted under the skin in the chest. They can be used to detect abnormal and potentially life-threatening heart rhythms, then to deliver a shock to restore normal rhythm.
Authors' recommendations:
Implications for Decision Making;
: ICDs, with optimal pharmacologic therapy, significantly reduce SCD and all-cause death in patients at high risk.
: ICDs are effective in reducing SCD in patients with ischemic and non-ischemic heart disease.
: ICD therapy is expensive but some reviewed studies showed that ICDs are cost-effective if the willingness to pay is 50,000 USD per quality adjusted life year (QALY). More study with a broader target population is warranted.
: Poor psychosocial outcomes in ICD patients may occur as a result of their underlying cardiac condition, rather than as a direct response to ICDs.
: ICD therapy for primary prevention of SCD would result in a substantial budget impact. There are also infrastructure issues that would need to be addressed in order to meet demand.
Authors' methods:
Systematic review, Cost study
Details
Project Status:
Completed
Year Published:
2007
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Canada
MeSH Terms
- Defibrillators, Implantable
- Death, Sudden, Cardiac
Contact
Organisation Name:
Canadian Agency for Drugs and Technologies in Health
Contact Address:
600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;
Contact Name:
requests@cadth.ca
Contact Email:
requests@cadth.ca
Copyright:
Canadian Agency for Drugs and Technologies in Health (CADTH)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.