Article Impact Level: HIGH Data Quality: STRONG Summary of Clinical Cardiology, 46(10), 1227–1233. https://doi.org/10.1002/clc.24107 Dr. Mengna Chen et al.
Points
- Cardiac resynchronization therapy (CRT) is an established treatment for heart failure patients, but triple-chamber pacemakers can be costly.
- His-Purkinje system pacing (HPSP) offers a lower-cost alternative to CRT using conventional pacemakers.
- The study compared the prices, designed life, and cost-effectiveness of various CRT-P, CRT-D, dual-chamber pacemakers, and single-chamber pacemakers in the Chinese market in 2022.
- The costs of CRT-P and CRT-D were significantly higher than those of conventional pacemakers, with average costs of 13,008.44 USD and 22,043.36 USD, respectively.
- Conventional pacemakers had a better price/designed life ratio than CRT-P and CRT-D, making HPSP-based CRT a more cost-effective option for heart failure patients who do not require defibrillation.
Summary
This research paper compares the cost-effectiveness of cardiac resynchronization therapy (CRT) strategies for heart failure patients. The study uses conventional pacemakers to implement triple-chamber pacemakers versus His-Purkinje system pacing (HPSP). The authors collected data on the prices, designed life, and price/designed life of various CRT-P, CRT-D, dual-chamber pacemakers, and single-chamber pacemakers available in the Chinese market in 2022. The costs and cost-effectiveness of these devices were then compared.
The results showed that the costs of CRT-P and CRT-D were significantly higher than conventional pacemakers. The average cost of CRT-P was 13,008.44 USD, while CRT-D cost 22,043.36 USD. In contrast, dual-chamber pacemakers cost 11,142.39 USD, and single-chamber pacemakers cost 5,634.28 USD. Additionally, conventional pacemakers’ price/designed life ratio was significantly better than that of CRT-P and CRT-D. The cost per year for dual-chamber pacemakers was 839.63 USD, and for single-chamber pacemakers, it was 435.86 USD. In comparison, CRT-P had a cost of 1,386.91 USD per year, and CRT-D had a cost of 2,585.53 USD per year.
In conclusion, the study suggests that His-Purkinje system pacing (HPSP)-based CRT is more cost-effective than triple-chamber pacemaker-based CRT. HPSP can achieve cardiac resynchronization using conventional pacemakers, making it a viable option for heart failure patients who do not require defibrillation. These findings provide valuable guidance for electrophysiologists in making informed clinical decisions regarding CRT strategies for their patients.
Link to the article: https://onlinelibrary.wiley.com/doi/10.1002/clc.24107
References Chen, M., Shi, J., Zhang, Y., Ge, X., Zhang, X., Fan, W., Wang, S., Guo, Z., Guan, J., Wu, Y., & Zhang, J. (2023). Comparative cost analysis of implanting devices in different cardiac resynchronization therapeutic strategies. Clinical Cardiology, 46(10), 1227–1233. https://doi.org/10.1002/clc.24107
