Boston Scientific welcomes the UK’s National Institute for Health and Care Excellence (NICE) guidance on the use of implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) for arrhythmias and heart failure. In the updated Technology Appraisal, people with ventricular arrhythmias are eligible for an ICD, which can help prevent cardiac arrest in those who have previously survived a life-threatening arrhythmia. In people with heart failure, CRT can improve life expectancy and quality of life. Boston Scientific looks forward to working with the UK’s National Health Service (NHS) to implement this guidance.
Nearly 75,000 people develop heart failure each year and a further one million people are affected by cardiac arrhythmia in the UK and with an ageing population the numbers are expected to rise. Heart failure constitutes one of the biggest hospitalisation costs facing the NHS in the UK with over 5% of emergency admissions and 2% of all NHS inpatient bed days.
“We are extremely pleased that the updated NICE guidance has now been published,” says Pierre Chauvineau, vice president, Rhythm Management Europe, Boston Scientific. “As patients live longer, we believe that increased device battery longevity is vital and can translate to fewer replacement procedures and a lower risk of complications. We believe that reducing re-intervention can also have an important impact on the UK health system, offering substantial savings to commissioners and increased efficiency for cardiac services able to treat more new patients at no additional costs. Boston Scientific ICDs and CRT-D devices have demonstrated unsurpassed longevity performance, which is backed by an industry leading warranty.”
NICE recommends ICDs as a treatment option for people with previous serious ventricular arrhythmia, people with familial cardiac conditions with a high risk of sudden death and people who have undergone surgery to repair congenital heart disease. Furthermore, NICE expands its recommendations on ICDs and CRT (CRT-P with pacing or CRT-D with pacing and defibrillation) for people with heart failure who have left ventricular dysfunction with an LVEF (left ventricular ejection fraction) of 35% or less.
“As clinicians, we are always looking to provide our patients with the most appropriate treatment specific to individual health care needs, and having a choice of devices is important. Now that we have the guidelines, we need to ensure they are put into practice so that patients eligible for ICD and CRT receive these devices, improving their standard of care,” comments Jay Wright, consultant cardiologist, Liverpool Heart and Chest Hospital, UK.
This guidance has been long awaited by patient groups with arrhythmias and heart failure. The guidance is also welcomed by clinicians treating these patients, as the increased patient eligibility for ICD and CRT therapies will improve access and help better manage these serious and life threatening conditions. In 2013, 8,151 patients were implanted with their first device.
“The NICE announcement has been a long time coming from the last guidance issued in 2006-2007, and we are very pleased by the recommendations, as many more patients are indicated for device therapies. Arrhythmia and heart failure are both serious and life threatening conditions that can have a significant impact on patients and their families,” says Trudie Lobban MBE, founder and chief executive officer, Arrhythmia Alliance.