title: Prehospital discharge defibrillation testing in ICD recipients: a prospective study based on cost analysis.
abstract: Prehospital discharge defibrillation testing is often performed to verify the function of newly implanted cardioverter defibrillators (ICDs). To determine whether elimination of predischarge testing could reduce costs without placing patients at additional risk, 31 patients were randomized in this prospective clinical evaluation to either receive or not receive a predischarge ICD defibrillation test. Expenses associated with postimplant care was the primary endpoint. All patients underwent induction of ventricular fibrillation after 6 months to evaluate ICD function. The groups were well matched in terms of patient characteristics, initial lead implant parameters, and defibrillation thresholds. Elimination of prehospital discharge testing resulted in a savings of $1,800/patient after 6 months, with no difference between groups in terms of ICD complication rates or unanticipated hospital admissions. Further studies are needed to better define the most appropriate time to assess defibrillation thresholds in the first year after implantation.
authors.affiliation: Cardiac Arrhythmia Center, University of Minnesota, Minneapolis 55455, USA. lurie002@maroon.tc.umn.edu
authors.forename: K G
authors.initials: KG
authors.lastname: Lurie
authors.forename: D
authors.initials: D
authors.lastname: Iskos
authors.forename: J
authors.initials: J
authors.lastname: Fetter
authors.forename: C A
authors.initials: CA
authors.lastname: Peterson
authors.forename: J M
authors.initials: JM
authors.lastname: Collins
authors.forename: J J
authors.initials: JJ
authors.lastname: Shultz
authors.forename: G J
authors.initials: GJ
authors.lastname: Fahy
authors.forename: S
authors.initials: S
authors.lastname: Sakaguchi
authors.forename: D G
authors.initials: DG
authors.lastname: Benditt
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000191:economics; D003362:Cost-Benefit Analysis; D017147:Defibrillators, Implantable / Q000191:economics; D004554:Electric Countershock / Q000191:economics / Q000295:instrumentation; D015716:Electrocardiography, Ambulatory; D004632:Emergency Medical Services / Q000191:economics / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics; D008297:Male; D006278:Medicare / Q000191:economics; D011446:Prospective Studies; D013686:Telemetry; D016896:Treatment Outcome; D014481:United States; D014693:Ventricular Fibrillation / Q000191:economics / Q000503:physiopathology / Q000628:therapy*