Related Experiment Video
Updated: Aug 9, 2026
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Cost effectiveness of biventricular pacemakers in heart failure patients
Adrienne Heerey1, Michael Lauer, Firas Alsolaiman
1Department of Medicine, National University of Ireland, Galway, Ireland. adrienneheerey@ireland.com
Insights
Biventricular pacemakers improve outcomes for heart failure (HF) patients. This study found that biventricular pacing is a cost-effective treatment option, dominating medical therapy in economic analyses.
Area of Science:
- Cardiology
- Health Economics
- Medical Technology
Background:
- Biventricular pacemakers reduce mortality and hospitalizations in heart failure (HF) patients with specific criteria (NYHA class III-IV, QRS >130 ms).
- High initial cost (approx. $33,500 USD) and battery replacement needs necessitate cost-effectiveness evaluation.
- Limited published data exists on the cost-effectiveness of cardiac resynchronization therapy.
Purpose of the Study:
- To determine the cost-effectiveness of biventricular pacing therapy compared to medical management for heart failure patients.
- To analyze the economic impact of cardiac resynchronization therapy from a healthcare perspective.
Main Methods:
- A cost-utility analysis was conducted using a Markov model.
- Data from HF patients receiving biventricular pacing at Cleveland Clinic Foundation was utilized.
- Probabilistic sensitivity analysis with second-order Monte-Carlo simulation assessed result variability over 1 and 5 years.
Main Results:
- Biventricular pacemaker treatment economically dominated medical treatment at both 1 and 5-year follow-up points.
- The analysis, from a healthcare perspective, indicated favorable economic outcomes for the intervention.
Conclusions:
- Biventricular device insertion represents an economically attractive treatment strategy for indicated heart failure patients.
- Cardiac resynchronization therapy offers a cost-effective solution for managing specific heart failure populations.
Background:
Biventricular pacemakers have been shown to reduce mortality and hospitalizations in heart failure (HF) patients and are indicated for those with a New York Heart Association functional class of III or IV and a QRS interval of >130 ms. However, these devices currently cost in the region of dollar US 33,500 and require replacement upon battery depletion. Therefore, determination of the cost effectiveness of resynchronization therapy is important, although little data have been published to date on this topic.
Methods And Results:
A cost-utility analysis from the healthcare perspective was performed using HF patients who received a biventricular pacing device in the Cleveland Clinic Foundation. The comparator was a similarly profiled group of patients who did not receive the device but were treated medically. A Markov model was used to investigate the cost effectiveness at 1 and 5 years. Second-order Monte-Carlo simulation was used to determine the variability in results, using probabilistic sensitivity analysis. Medical treatment was dominated by biventricular pacemaker treatment at both 1 and 5 years of follow-up.
Conclusion:
Biventricular device insertion is an economically attractive treatment option for clinically indicated HF patients.
More Related Videos
Related Concept Videos
01:30Heart Failure V: Medical Management
01:26Heart Failure Drugs: Inotropic Agents
01:29Cardiomyopathy V: Interprofessional Care
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:22Heart Failure VI: Adjunct Therapies
01:29Heart Failure II: Pathophysiology