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Updated: Aug 3, 2026

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
16:40

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation

Published on: February 28, 2012

Cost-effectiveness of the implantable cardioverter defibrillator

Mark A Hlatky1, Gillian D Sanders, Douglas K Owens

  • 1Department of Health Research and Policy, Stanford University School of Medicine, CA 94305-5405, USA. hlatky@stanford.edu

Cardiac Electrophysiology Review
|April 9, 2004
PubMed

Insights

The implantable defibrillator (ICD) offers improved survival but at a high cost. Its cost-effectiveness is favorable in high-risk patients who gain at least six months of life.

Area of Science:

  • Cardiovascular Medicine
  • Health Economics
  • Medical Technology Assessment

Background:

  • High cost of implantable defibrillators (ICDs) raises concerns about clinical and economic justification.
  • Previous randomized trials have investigated the economic outcomes of ICDs.

Purpose of the Study:

  • To evaluate the cost-effectiveness of implantable defibrillators (ICDs) compared to conventional therapy.
  • To identify patient subgroups where ICD use is economically attractive.

Main Methods:

  • Analysis of economic outcomes from three randomized trials of ICDs.
  • Calculation of cost-effectiveness (CE) ratios, measured in dollars per life year added.

Main Results:

  • All trials showed higher costs for ICD patients versus conventional therapy over 3-6 years.
  • ICD patients experienced improved survival across all trials.
  • Calculated ICD cost-effectiveness ratios ranged from $27,000 to $139,000 per life year added.

Conclusions:

  • Variability in cost-effectiveness ratios is linked to differences in life years gained by ICDs.
  • ICDs are economically attractive when they extend mean survival by six months or more.
  • Higher-risk patient subgroups are more likely to achieve this survival benefit, making ICDs more justifiable.

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