Implantable Cardioverter Defibrillator Shock-Related Healthcare Utilization Trends

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Invasive cardiovascular procedures were also utilized after both appropriate and inappropriate shocks.
Invasive cardiovascular procedures were also utilized after both appropriate and inappropriate shocks.

HealthDay News – Healthcare utilization (HCU) is common after appropriate and inappropriate implantable cardioverter defibrillator shock events, according to a study published online in Circulation: Cardiovascular Quality and Outcomes.

Mintu P. Turakhia, MD, from Stanford University School of Medicine in California, and colleagues conducted a retrospective cohort study of patients with implantable cardioverter defibrillators identified from commercial and Medicare claims databases linked to adjudicated shock events from remote monitoring data. Based on inpatient and outpatient claims within 7 days after a shock event, they ascertained shock-related HCU.

The researchers found that 963 (9.4%) of 10,266 linked patients had 1885 shock events (56%, 38%, and 6% were appropriate, inappropriate, and indeterminate, respectively). Shock-related HCU occurred in 46% of these events (14% and 32% inpatient and outpatient, respectively). Inpatient cardiovascular procedures were common after shocks, including echocardiography, electrophysiology study or ablation, stress testing, and lead revision (59%, 34%, 16%, and 11%, respectively). 

After appropriate and inappropriate shocks, cardiac catheterization was common (71% and 51%, respectively), while percutaneous coronary intervention was low (6.5% and 5%, respectively). There was no significant difference in expenditures related to appropriate and inappropriate shocks.

"Use of invasive cardiovascular procedures was substantial, even after inappropriate shocks, which comprised 38% of all shocks," the authors wrote.

Disclosures: Several authors disclosed financial ties to Medtronic and St. Jude Medical.

Reference

Turakhia MP, Zweibel S, Swain AL, Mollenkopf SA, Reynolds MR. Healthcare utilization and expenditures associated with appropriate and inappropriate implantable defibrillator shocks [published February 14, 2017]. Circ Cardiovasc Qual Outcomes. doi:10.1161/CIRCOUTCOMES.115.002210

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