title: Transvenous cardioverter defibrillators: cost implications of a less invasive approach.
abstract: To assess the economic impact of a transvenous lead system for an implantable cardioverter defibrillator (ICD), we evaluated the hospital charges for two groups of patients: group I patients (n = 23) underwent implantation of an ICD generator with an epicardial lead system via a thoracotomy and group II patients (n = 25) underwent implantation of the same generator using transvenous leads. There was no difference in demographics between the two groups. There was a 15% decrease in total charges for the transvenous group compared to the thoracotomy group ($54,142 vs $63,359, P < 0.05). Evaluation of the component charges revealed that the decline could be attributed to a reduction in implant ($27,328 vs $29,285, P < 0.02) and convalescent charges ($7,703 vs $15,179, P < 0.01) for the transvenous group. There was a corresponding decrease in length of stay for the transvenous group (22 vs 29 days, P < 0.05) largely secondary to a 38% reduction in convalescent length of stay (8 vs 13 days, P < 0.05). We conclude that the use of transvenous lead systems for the ICD results in a significant reduction in hospital charges as well as hospital length of stay.
authors.affiliation: Cardiac Electrophysiology Laboratory, Lahey Clinic Medical Center, Burlington, Massachusetts 01805, USA.
authors.forename: F J
authors.initials: FJ
authors.lastname: Venditti
authors.forename: M
authors.initials: M
authors.lastname: O'Connell
authors.forename: D T
authors.initials: DT
authors.lastname: Martin
authors.forename: D M
authors.initials: DM
authors.lastname: Shahian
mesh_terms: D000368:Aged; D003289:Convalescence; D003362:Cost-Benefit Analysis; D017147:Defibrillators, Implantable / Q000191:economics*; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay; D008297:Male; D008722:Methods; D008875:Middle Aged; D013908:Thoracotomy; D014680:Veins