1. Effects of enhanced pacing modalities on health care resource utilization and costs in bradycardia patients: An analysis of the randomized MINERVA trial
- Author
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BORIANI, GIUSEPPE, DIEMBERGER, IGOR, Manolis, Antonis S., Tukkie, Raymond, Mont, Lluis, Pürerfellner, Helmut, Santini, Massimo, Inama, Giuseppe, Serra, Paolo, Gulizia, Michele, Samoilenko, Igor Vasilyevich, Wolff, Claudia, Holbrook, Reece, Gavazza, Federica, Padeletti, Luigi, on behalf of the MINERVA Investigators: [. . ., Boriani, Giuseppe, Manolis, Antonis S., Tukkie, Raymond, Mont, Llui, Pürerfellner, Helmut, Santini, Massimo, Inama, Giuseppe, Serra, Paolo, Gulizia, Michele, Samoilenko, Igor Vasilyevich, Wolff, Claudia, Holbrook, Reece, Gavazza, Federica, Padeletti, Luigi, on behalf of the MINERVA Investigators: [.., Igor Diemberger, and ]
- Subjects
Bradycardia ,United State ,medicine.medical_specialty ,Rate ratio ,Cost Savings ,Internal medicine ,Physiology (medical) ,Atrial Fibrillation ,medicine ,media_common.cataloged_instance ,Humans ,Pacing ,European Union ,European union ,media_common ,Health Resource ,Cost Saving ,business.industry ,Cardiac Pacing, Artificial ,Atrial fibrillation ,Emergency department ,medicine.disease ,United States ,Hospitalization ,Healthcarecosts ,Pacemakeralgorithms ,Atrial Flutter ,Health Resources ,Cardiology and Cardiovascular Medicine ,Heart failure ,Antitachycardia Pacing ,Cardiology ,Healthcarecost ,medicine.symptom ,Pacemakeralgorithm ,business ,Atrial flutter ,Human - Abstract
Background Many patients who suffer from bradycardia and need cardiac pacing also have atrial fibrillation (AF). New pacemaker algorithms, such as atrial preventive pacing and atrial antitachycardia pacing (DDDRP) and managed ventricular pacing (MVP), have been specifically designed to reduce AF occurrence and duration and to minimize the detrimental effects of right ventricular pacing. The randomized MINimizE Right Ventricular pacing to prevent Atrial fibrillation and heart failure trial established that DDDRP + MVP pacing modality reduced permanent AF in bradycardia patients as compared with standard dual-chamber pacing (DDDR). Objective The aim of this study was to estimate the cost savings due to lower AF-related health care utilization events based on health care costs from the United States and the European Union. Methods Dual-chamber pacemaker patients with a history of paroxysmal or persistent AF were randomly assigned to receive DDDR (n = 385) or the advanced features (DDDRP + MVP; n = 383). We used published health care costs from the United States and the European Union (Italy, Spain, and the United Kingdom) to estimate the costs associated with AF-related hospitalizations and emergency visits. Results The rate of AF-related hospitalizations was significantly lower in the DDDRP + MVP group than in the conventional pacemaker group (DDDR group; 42% reduction; incidence rate ratio 0.58). Similarly, a significant reduction of 68% was observed for AF-related emergency department visits (incidence rate ratio 0.32; P
- Published
- 2014