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Researchers at the University
of Pennsylvania’s School of Medicine have discovered
that implantable cardioverter-defibrillators (ICDs) -- electric
monitoring devices that deliver a lifesaving shock in the event
of a cardiac arrest -- help patients with heart problems live
longer more active lives. |
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Further, the study found most patients living
with ICDs enjoy a quality of life consistent with average Americans
their age and have a high level of satisfaction with the device,
offsetting longstanding perceptions that the technology extends
but seriously impairs patients’ lives. |
> |
The researchers report their findings in the April 2007 issue
of the journal Pacing and Clinical Electrophysiology. |
(PHILADELPHIA) – Researchers at the University
of Pennsylvania’s School of Medicine have discovered
that implantable
cardioverter-defibrillators (ICDs) -- electric
monitoring devices that deliver a lifesaving shock in the event
of a cardiac
arrest -- help patients with heart problems live
longer more active lives. Further, the study found most patients
living with ICDs enjoy a quality of life consistent with average
Americans their age and have a high level of satisfaction with
the device, offsetting longstanding perceptions that the technology
extends but seriously impairs patients’ lives. Peter
Groeneveld, MD, MS , Assistant Professor
of General Internal
Medicine and his co-authors report their
findings in the April 2007 issue of the journal Pacing
and Clinical Electrophysiology.
The
study is the first to analyze quality of life and cost in "primary
prevention" ICD patients, that is patients with no prior history
of abnormal
heart rhythms, but whose heart disease may increase
their risk of sudden cardiac death. It is also among the first
to verify the effectiveness of ICDs in patients who were not enrolled
in clinical trials.
The
use of ICDs has rapidly increased in recent years, particularly
since Medicare and other health payers expanded coverage of the
device for primary prevention. Nearly 50,000 implants were
performed in 2005 in the United States, alone, making it among
the most common cardiovascular device used in contemporary clinical
practice.
“While the lifesaving benefits of ICDs have been well documented
over the last decade, little was known about the experience of
patients in the real world post implantation. This study looked
at a population that better represents current device recipients,
which in turn, means that physicians can now communicate a more
accurate description about life with the device to patients,” said
Groeneveld.
Lifesaving Benefits, Return to Active Life, and Reduced
Cost
Researchers administered a comprehensive patient
survey to better understand quality of life benefits, for both
primary prevention and "secondary prevention" ICD patients, i.e.,
patients who have already experienced a cardiac event.
Key findings include:
- Patients
living with an ICD report high levels of emotional, physical
and functional well-being, and are satisfied and able to adapt
to living with the device.
- When
analyzed against a control population, their experiences are
comparable to average Americans of the same age.
- Driving,
lifting heavy objects and sexual activity were the most common
lifestyle concerns voiced by ICD patients during the quality
of life survey, suggesting that physicians should routinely address
these issues with patients when communicating expectations of
living with the device and throughout long-term care.
According to Groeneveld, the quality of life benefits emerge from
advances in ICD technology over the last decade resulting in smaller,
more easily programmed devices which can more accurately respond
to the needs of the individual patient.
"With an estimated one million Americans eligible for implantation
today, it is extremely important to verify that ICDs deliver value
on par with the health care dollars expended in most heart patients,
even among the elderly," he said.
The research team also included Mary Anne Matta, MS, University
of Pennsylvania School of Medicine; Feifei Yang, MS, University
of Pennsylvania School of Medicine; Janice J. Suh, BS, University
of Pennsylvania School of Medicine; Judy A. Shea, PhD, University
of Pennsylvania School of Medicine; J.
Sanford Schwartz, MD, University
of Pennsylvania School of Medicine and The
Wharton School, University
of Pennsylvania; Paul
A. Heidenreich, MD, MS, Stanford
University School of Medicine and United
States Department of Veterans Affairs;
and Mark
V. Pauly, PhD, The Wharton School, University of Pennsylvania.
This research was supported by an unrestricted grant from The
Institute for Health Technology Studies (InHealth), a Washington
nonprofit organization that supports research and analysis
of the economic, social, and health effects of patient access to
medical technology innovation. Dr. Groeneveld was additionally
supported by a Research
Career Development Award from the Department
of Veterans Affairs Health Services Research and Development Service.
###
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