New data showing the use of Medtronic’s cardiac resynchronisation therapy (CRT) devices—with its proprietary AdaptivCRT and EffectiveCRT algorithms—to result in lower healthcare system costs and improved therapy delivery in heart failure patients who also have atrial fibrillation (AF), have been presented at EHRA EUROPACE-CARDIOSTIM 2017 in Vienna, Austria.
Findings from a European health-economic analysis demonstrated that treating patients with AdaptivCRT results in lower healthcare costs and extends life expectancy by an average of four months. The findings, which span three countries’ healthcare systems, showed that lifetime costs for patients treated with AdaptivCRT were lower than for patients treated with traditional pacing algorithms:
|With AdaptivCRT algorithm||Without AdaptivCRT algorithm|
|United Kingdom||€29,425.37 (£25,454.47)||€30,273.19 (£26,274.39)|
The AdaptivCRT algorithm is is designed to adjust the way the device paces the heart according to minute-to-minute evaluations of each patient’s rhythm, and leads to improved outcomes through reducing patients’ odds of a 30-day heart failure readmission and their risk of developing AF. It is available in the Medtronic Claria MRI Quad CRT-D SureScan, Amplia MRI Quad CRT-D SureScan, Percepta Quad CRT-P MRI SureScan and Serena Quad CRT-P MRI SureScan systems.
A second analysis—from the prospective, randomised CRTee study—showed that the Medtronic device-based EffectivCRT during AF algorithm improved effective left ventricular pacing by 19% (87±16% vs. 68±37%; p<0.001) in patients with AF, compared to devices without the technology.
“It is exciting to see that this technology helps increase the amount of CRT delivered during atrial fibrillation,” says Giuseppe Boriani, professor of cardiology at the University of Modena and Reggio Emilia, Modena, Italy. “Many patients with heart failure experience AF at some point, and we now have the ability to better address the individual needs of these difficult-to-treat patients.”
A large percentage of heart failure patients receiving CRT also have AF, which can significantly reduce patient response to the therapy. The EffectivCRT Diagnostic, exclusive to the Medtronic Claria CRT-D and Percepta CRT-P devices, is designed to automatically determine the effectiveness of left ventricular pacing, whilst the EffectivCRT during AF algorithm is intended to automatically adjust pacing rates during AF.
Finally, the latest economic analysis of Medtronic CRT-defibrillators (CRT-D) presented at the conference demonstrated a highly significant increase in projected device longevity: up to nine years for Claria and Amplia devices, and 8.1 years in Viva XT CRT-Ds, which are substantial improvements compared to predecessor models.
“By improving device longevity, there are substantially fewer device replacements and, in turn, significant cost savings and fewer procedure-related complications,” said Haran Burri, associate professor of cardiology at the University Hospital of Geneva, Geneva, Switzerland.