Effects of ICD implantation on quality-adjusted life years in patients with congestive heart failure.
BACKGROUND
Effects of prophylactic implantable cardioverter-defibrillator (ICD) on quality-adjusted life years (QALYs) in patients with congestive heart failure are uncertain.


METHODS
We developed a decision model for patients at risk of sudden death due to reduced ejection fraction and who had no history of life-threatening ventricular arrhythmias. It estimated the QALYs for ICD strategy as a primary prevention for sudden cardiac death and conventional strategy without antiarrhythmic therapies.


RESULTS
In a 3-year time period, the QALYs for patients with conventional strategy were higher than that of ICD strategy (2.19 years vs. 2.14 years). When the mortality rate of conventional strategy exceeded 8.6%/year and the hazard ratio of death for the ICD strategy was lower than 0.70, the ICD strategy was the superior treatment option.


CONCLUSIONS
The QALYs of patients with ICD could be lower than that of conventional strategy. Incorporating quality of life could affect decision making of ICD implantation.
Ozasa
Neiko
N
Morimoto
Takeshi
T
Furukawa
Yutaka
Y
Shizuta
Satoshi
S
Nishiyama
Kei
K
Kita
Toru
T
Kimura
Takeshi
T
D003661:Decision Support Techniques; D017147:Defibrillators, Implantable; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D011788:Quality of Life