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Is the CRT-D’s Costly Investment for Heart Health Worth It?

Posted Sep 17 2009 10:20pm

Please welcome Hannah Watson, who has written a guest post today on the topic of CRT-Ds.  Thanks Hannah for adding some quality information to the blog! 

She writes about theonline nursing programand  welcomes your feedback at HannahWatson84@ yahoo.com. 

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A recent study shows that a new heart implant device, called the cardiac-resynchronization therapy device and defibrillator, or CRT-D, reduced hospitalizations due to heart failure by 41 percent, the Los Angeles Times reported. The device shocks the heart into beating regularly and on time if it is beating erratically, such as during a heart attack. The results of the study, published online in the New England Journal of Medicine, suggested that the CRT-D’s hybrid of a cardiac synchronizer and defibrillator is more effective than either of the devices alone. 

The size of a cell-phone, the CRT-D is implanted in 60,000 patients with severe heart disease every year, the Los Angeles Times reports. The implantable device can reanimate a stalled heart, just as a defibrillator can, and also keep the heart beating in the rhythm it is supposed to be beating. But researchers are exploring the option of implanting the device in those with milder forms of heart disease, which makes up 70 percent of all American heart failure patients.

“The theme of this study is to put the device in patients earlier,’’ David S. Cannom, co principal investigator for the heart study and director of cardiology at Good Samaritan Hospital in Los Angeles, told the Boston Globe. “We don’t want to wait until they have progressed to advanced heart failure. This is preventing trouble rather than waiting for it to happen.’’ image

But the hefty price tag may make the implant a dud rather than a scientific breakthrough in medicine. Each device costs about $30,000, not including the $10,000 to $15,000 hospital and surgical fee. On the other hand, a defibrillator implant costs only $20,000. With such a huge gap between costs, researchers are wondering if getting implanted with the fancy CRT-D is a worthwhile investment. Having the implant does not necessarily mean that patients will survive a cardiac arrest or the progression of heart disease, though it will cut down on the need for hospitalization. Some are arguing that this alone justifies the major difference in prices between the CRT-D and single defibrillator implants. Those hospitalized for heart failure are likely to be hospitalized again, which can add up in terms of costs over the visits. Therefore, the savings from the reduced number of hospital visits for those wearing the CRT-D balances out its $10,000 difference in cost.

Yet, it is notable that the rate of death from heart failure among women in the study was the same with or without the implant. This means that while the CRT-D keeps heart patients out of hospitals longer, it does not lengthen the lives of those patients.

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