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Updated: Jul 3, 2026
Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
Cost effectiveness of cardiac resynchronization therapy in the Nordic region: an analysis based on the CARE-HF trial
P Blomström1, M Ekman, C Blomström Lundqvist
1Department of Cardiology, University Hospital in Uppsala, Stockholm, Sweden. per.blomstrom@akademiska.se
Insights
Cardiac resynchronization therapy (CRT) is cost-effective for heart failure patients in Scandinavia. This treatment offers significant health benefits and is recommended for routine use.
Area of Science:
- Cardiology
- Health Economics
Background:
- Investigated the cost-effectiveness of cardiac resynchronization therapy (CRT) in Denmark, Finland, and Sweden.
- Utilized data from the CARE-HF trial, comparing CRT with optimal pharmacological treatment in heart failure patients with dyssynchrony.
Purpose of the Study:
- To evaluate the economic value of CRT in Scandinavian healthcare systems.
- To determine if CRT is a cost-effective addition to standard heart failure management.
Main Methods:
- Health effects measured using quality-adjusted life years (QALYs) gained.
- Combined CARE-HF trial data with regional cost data for CRT implantation and hospitalization.
- Calculations based on expected patient lifetime and a 6-year device lifespan for CRT.
Main Results:
- Cost-effectiveness ratios per QALY gained were €4800 (Denmark), €3600 (Finland), and €6700 (Sweden).
- Confidence intervals for cost per QALY were consistently below cost-effectiveness thresholds in all three countries.
- The 95% confidence intervals ranged from €1169 (Finland) to €17,482 (Sweden).
Conclusions:
- Cardiac resynchronization therapy (CRT) is a cost-effective treatment in Scandinavian healthcare settings.
- CRT is recommended for routine use in patients with moderate to severe heart failure and cardiac dyssynchrony.
- The findings support the integration of CRT into standard care for eligible heart failure patients.
Background:
The aim of this study was to investigate the cost-effectiveness of cardiac resynchronization therapy (CRT) in Denmark, Finland and Sweden. The analysis was based on the CARE-HF trial, a randomised clinical trial investigating the efficacy of adding CRT (n=409) to optimal pharmacological treatment (n=404) in patients with moderate to severe heart failure with markers of cardiac dyssynchrony. The average follow-up time was 29.4 months.
Methods:
The health effects were measured in terms of quality-adjusted life years (QALYs) gained. Data on health care resource consumption from CARE-HF was combined with costs for CRT implantation and hospitalisation from university hospitals in Denmark, Finland and Sweden. Calculations were based on patients' expected life time. The expected device lifetime (6 years) was used for CRT, and no additional gains in clinical effects were assumed after the 6 years.
Results:
The cost-effectiveness ratio per QALY gained was 4800 euros in Denmark, 3600 euros in Finland and 6700 euros in Sweden. The 95% confidence intervals for the cost per QALY gained varied between a lower limit of 1169 euros in Finland to an upper limit of 17,482 euros in Sweden. These values were all below the threshold for being cost-effective in Denmark, Finland and Sweden.
Conclusions:
The study indicates that CRT is a cost-effective treatment in Scandinavian health care settings compared to traditional pharmacological therapy and can therefore be recommended for routine use in patients with moderate to severe heart failure and markers of dyssynchrony.
