Friday, May 21, 2004
Thanks, Rick, for passing along this article!
Dual-chamber pacemakers can cut death risk up to 50% Study is the largest
yet of heart failure device
By Steve Sternberg
USA TODAY
Devices that synchronize the two halves of the failing heart and shock
hearts that falter cut the risk of death by more than one-third, a study
reports today.
The study, called Companion, involved 1,520 patients with heart failure,
progressive weakening of the heart muscle. It is the first major test of
dual-chamber pacemaker defibrillators in patients with heart failure from
all causes. The devices cut deaths plus hospitalizations by 34%.
As for death rates alone, the pacemakers reduced mortality by 36% overall
-- and by 50% in people whose heart failure did not result from a heart
attack. That's in addition to the 30% reduction patients get from the
best medication, says study leader Michael Bristow of the University of
Colorado-Denver.
''A 50% reduction in mortality is unbelievably large, especially on top
of medical therapy,'' Bristow says. ''It should become the standard of
care in this population.''
The risk of death dropped by 27% in people who developed heart failure
after having a heart attack, says the study in today's New England
Journal of Medicine.
A separate study of 458 heart failure patients, reported in the same
journal, found that defibrillators cut the risk of death from rhythm
disturbances almost in half, from 14% to 8%.
Two years ago, positive findings from a study called Madeit II prompted
Medicare and private insurers to pay for the $30,000 device, but only for
those with heart failure from heart attacks.
Roughly 5 million Americans have heart failure, also caused by viral
infection, alcoholism, high blood pressure, clogged arteries and factors
still unknown. Doctors say as many as 100,000 could benefit from the
special pacemakers, because the electrical pulses controlling their
heartbeat take longer to cross from one pumping chamber to another.
''These devices have great promise,'' says David Meyerson of Johns
Hopkins University and the American Heart Association. ''We're seeing
improved functional capacity, fewer hospitalizations and improved
survival beyond that from the best medicines alone.''
Some doctors have asked whether the device's expense will drain Medicare,
but Beverly Lorell, chief medical officer for Guidant, the study's
sponsor, says her company's device prevents costlier hospitalizations.
Hospital costs for heart failure are staggering, she says. Hospital bills
account for $14 billion of the $24 billion that will be spent on heart
failure in the USA this year. She says a study is underway to determine
whether the device is cost-effective.
© Copyright 2004 USA TODAY, a division of Gannett Co. Inc.
Dual-chamber pacemakers can cut death risk up to 50% Study is the largest
yet of heart failure device
By Steve Sternberg
USA TODAY
Devices that synchronize the two halves of the failing heart and shock
hearts that falter cut the risk of death by more than one-third, a study
reports today.
The study, called Companion, involved 1,520 patients with heart failure,
progressive weakening of the heart muscle. It is the first major test of
dual-chamber pacemaker defibrillators in patients with heart failure from
all causes. The devices cut deaths plus hospitalizations by 34%.
As for death rates alone, the pacemakers reduced mortality by 36% overall
-- and by 50% in people whose heart failure did not result from a heart
attack. That's in addition to the 30% reduction patients get from the
best medication, says study leader Michael Bristow of the University of
Colorado-Denver.
''A 50% reduction in mortality is unbelievably large, especially on top
of medical therapy,'' Bristow says. ''It should become the standard of
care in this population.''
The risk of death dropped by 27% in people who developed heart failure
after having a heart attack, says the study in today's New England
Journal of Medicine.
A separate study of 458 heart failure patients, reported in the same
journal, found that defibrillators cut the risk of death from rhythm
disturbances almost in half, from 14% to 8%.
Two years ago, positive findings from a study called Madeit II prompted
Medicare and private insurers to pay for the $30,000 device, but only for
those with heart failure from heart attacks.
Roughly 5 million Americans have heart failure, also caused by viral
infection, alcoholism, high blood pressure, clogged arteries and factors
still unknown. Doctors say as many as 100,000 could benefit from the
special pacemakers, because the electrical pulses controlling their
heartbeat take longer to cross from one pumping chamber to another.
''These devices have great promise,'' says David Meyerson of Johns
Hopkins University and the American Heart Association. ''We're seeing
improved functional capacity, fewer hospitalizations and improved
survival beyond that from the best medicines alone.''
Some doctors have asked whether the device's expense will drain Medicare,
but Beverly Lorell, chief medical officer for Guidant, the study's
sponsor, says her company's device prevents costlier hospitalizations.
Hospital costs for heart failure are staggering, she says. Hospital bills
account for $14 billion of the $24 billion that will be spent on heart
failure in the USA this year. She says a study is underway to determine
whether the device is cost-effective.
© Copyright 2004 USA TODAY, a division of Gannett Co. Inc.
